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RISS 인기검색어
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- 저자 : Yoshiharu Taguchi (검색결과 2 건)
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Predictors of Poor Outcome in Patients with Acute Cerebral Infarction
Nobuhiro Dougu,Shutaro Takashima,Etsuko Sasahara,Yoshiharu Taguchi,Shigeo Toyoda,Tadakazu Hirai,Takashi Nozawa,Kortaro Tanaka,Hiroshi Inoue 대한신경과학회 2011 Journal of Clinical Neurology Vol.7 No.4
Background and Purpose Plasma D-dimer levels are elevated during the acute phase of cerebral infarction (CI). We investigated whether the D-dimer level on admission and other clinical characteristics could be used to predict the poor outcome of patients with acute CI. Methods The clinical characteristics and plasma D-dimer levels measured within 3 days of onset were compared according to outcome among patients with acute CI. Results In total, 359 consecutive patients (mean age, 71.8 years) were examined, of which 174 had a poor outcome [score on the modified Rankin scale (mRS) ≥3] at 30 days after hospitalization. The mean mRS score was higher and a poor outcome was observed more frequently among women than among men (p<0.001 for each). The proportions of women, cardioembolism, atrial fibrillation, advanced age (≥75 years), prior history of CI or transient ischemic attack, and elevated D-dimer level (≥1.0 μg/mL) were significantly higher among patients with a poor outcome than among those with a good outcome. A multivariate analysis showed that elevated D-dimer level [≥1.0 μg/mL; odds ratio (OR), 2.45; 95% confidence interval (95% CI),1.52-3.89; p<0.01], advanced age (OR, 1.93; 95% CI, 1.21-3.07; p<0.01), and female gender (OR, 1.75; 95% CI, 1.08-2.83; p=0.02) were independent predictors of a poor outcome. Conclusions Certain clinical characteristics (gender and advanced age) and an elevated Ddimer level upon admission can be used to predict the outcome of patients with acute CI at 30 days after hospitalization.
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Shutaro Takashima,Keiko Nakagawa,Tadakazu Hirai,Nobuhiro Dougu,Yoshiharu Taguchi,Etsuko Sasahara,Kazumasa Ohara,Nobuyuki Fukuda,Kortaro Tanaka 대한신경과학회 2012 Journal of Clinical Neurology Vol.8 No.3
Background and Purpose Not only clinical factors, including the CHADS2 score, but also echocardiographic findings have been reported to be useful for predicting the risk of ischemic stroke in patients with nonvalvular atrial fibrillation (NVAF). However, it remains to be determined which of these factors might be more relevant for evaluation of the risk of stroke in each patient. Methods In 490 patients with NVAF who underwent transesophageal echocardiography (TEE),we examined the long-term incidence of ischemic stroke events (mean follow-up time, 5.7±3.3years). For each patient, the predictive values of gender, the CHADS2 risk factors (congestive heart failure, hypertension, age =75 years, diabetes mellitus, history of cerebral ischemia), the CHADS2score, and the findings on echocardiography, including TEE risk markers, were assessed. Results The ischemic stroke rate was significantly correlated with the CHADS2 score (p<0.05). According to the results of univariate analyses, age =75 years, history of cerebral ischemia, CHADS2score =2, and presence of TEE risk were significantly correlated with the incidence of ischemic stroke. Cox proportional hazards regression analyses identified age =75 years and presence of TEE risk as significant predictors of subsequent ischemic stroke events in patients with NVAF. As compared with that in persons below 75 years of age without TEE risk, the ischemic stroke rate was significantly higher in persons who were =75 years of age with TEE risk (4.3 vs. 0.56%/year,adjusted hazard ratio=8.94, p<0.001). Conclusions TEE findings might be more relevant predictors of ischemic stroke than the CHADS2score in patients with NVAF. The stroke risk was more than 8-fold higher in patients aged =75 years with TEE risk.
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