허혈뇌졸중의 중증도와 장애 정도에 대한 뇌졸중 위험인자와의 연관성 = Relation of Stroke Risk Factors to Severity and Disability after Ischemic Stroke

다국어 초록 (Multilingual Abstract)

Background: The role of stroke risk factors as a determinant of clinical outcome is not well established. This study aimed to evaluate the prognostic value of stroke risk factors in patients with ischemic stroke by determining whether or not they contribute to stroke severity and disability after ischemic stroke. Methods: Subjects were 433 patients with ischemic stroke. National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to assess the severity of neurological deficit and clinical disability respectively. Multiple linear regression analysis was performed to evaluate the relation of stroke risk factors to stroke severity and disability. Results: Among stroke risk factors, atrial fibrillation was significantly correlated with NIHSS (P <0.001) and mRS scores (P =0.006). Hypertension and age were significantly correlated with mRS scores (P =0.010, P =0.018, respectively). Conclusion: Atrial fibrillation was an independent factor associated with severe stroke and disability. Hypertension, and older age were independently correlated with serious disability after ischemic stroke.

참고문헌 (Reference)

1 박태환, "한국인에서 허혈성 뇌졸중에 대한 주요 위험인자들의 인구기여위험도" 대한뇌졸중학회 10 (10): 125-133, 2008

2 Kimura K, "for the Japan Multicenter Stroke Investigators’ Collaboration (J-MUSIC). Atrial fibrillation as a predictive factor for severe stroke and early death in 15,831 patients with acute ischaemic stroke" 76 : 679-683, 2005

3 Frank B, "VISTA Col laborators. Impact of atrial fibrillation on outcome in thrombolyzed patients with stroke: evidence from the Virtual International Stroke Trials Archive (VISTA)" 43 : 1872-1877, 2012

4 Vemmos KN, "U-shaped relationship between mortality and admission blood pressure in patients with acute stroke" 255 : 257-265, 2004

5 Carlberg B, "The prognostic value of admission blood pressure in patients with acute stroke" 24 : 1372-1375, 1993

6 International Stroke Trial Collaborative Group, "The International Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke" 349 : 1569-1581, 1997

7 Lin HJ, "Stroke severity in atrial fibrillation. The Framingham Study" 27 : 1760-1764, 1996

8 Russo T, "Stroke in the very old: a systematic review of studies on incidence, outcome, and resource use" 2011 : 1-6, 2011

9 Hannon N, "Stroke associated with atrial fibrillation: incidence and early outcomes in the north Dublin population stroke study" 29 : 43-49, 2010

10 김재국, "Stroke Update: 위험인자 및 일차예방" 대한뇌졸중학회 14 (14): 12-18, 2012

11 Pinto A, "Risk factors profile and clinical outcome of ischemic stroke patients admitted in a Department of Internal Medicine and classified by TOAST classification" 25 : 261-267, 2006

12 Schwammenthal Y, "Relation of effective anticoagulation in patients with atrial fibrillation to stroke severity and survival (from the National Acute Stroke Israeli Survey [NASIS])" 105 : 411-416, 2010

13 Shimizu H, "Re-evaluation of clinical features and risk factors of acute ischemic stroke in Japanese longevity society" 55 : 132-139, 2010

14 Go AS, "Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study" 285 : 2370-2375, 2001

15 Jeong Joon Hoon, "Prevalence of and Risk Factors for Atrial Fibrillation in Korean Adults Older than 40 Years" 대한의학회 20 (20): 26-, 2005

16 Rothwell PM, "Population-based study of event-rate, incidence, case fatality, and mortality for all acute vascular events in all arterial territories (Oxford Vascular Study)" 366 : 1773-1783, 2005

17 Fiorelli M, "Italian Acute Stroke Study Group. Prediction of long-term outcome in the early hours following acute ischemic stroke" 52 : 250-255, 1995

18 Chen RL, "Ischemic stroke in the elderly: an overview of evidence" 6 : 256-265, 2010

19 Stead LG, "Initial emergency department blood pressure as predictor of survival after acute ischemic stroke" 65 : 1179-1183, 2005

20 Wilson JT, "Improving the assessment of outcomes in stroke: use of a structured interview to assign grades on the modified Rankin Scale" 33 : 2243-2246, 2002

21 Leonardi-Bee J, "IST Collaborative Group. Blood pressure and clinical outcomes in the International Stroke Trial" 33 : 1315-1320, 2002

22 Ahmed N, "High initial blood pressure after acute stroke is associated with poor functional outcome" 249 : 467-473, 2001

23 Willmot M, "High blood pressure in acute stroke and subsequent outcome: a systematic review" 43 : 18-24, 2004

24 Manabe Y, "High blood pressure in acute ischemic stroke and clinical outcome" 1 : 1-, 2009

25 Saku Y, "Hemorrhagic infarct induced by arterial hypertension in cat brain following middle cerebral artery occlusion" 21 : 589-595, 1990

26 Heuschmann PU, "German Stroke Registers Study Group. Predictors of in-hospital mortality and attributable risks of death after ischemic stroke" 164 : 1761-1768, 2004

27 Abboud H, "GENIC Investigators. High blood pressure in early acute stroke: a sign of a poor outcome?" 24 : 381-386, 2006

28 Karataş M, "Functional outcome in stroke patients with atrial fibrillation" 81 : 1025-1029, 2000

29 Lamassa M, "Characteristics, outcome, and care of stroke associated with atrial fibrillation in Europe: data from a multicenter multinational hospital-based registry (The European Community Stroke Project)" 32 : 392-398, 2001

30 Auriel E, "Characteristics of first ever ischemic stroke in the very elderly: profile of vascular risk factors and clinical outcome" 113 : 654-657, 2011

31 CAST (Chinese Acute Stroke Trial) Collaborative Group, "CAST: randomised placebo-controlled trial of early aspirin use in 20,000 patients with acute ischaemic stroke" 349 : 1641-1649, 1997

32 Castillo J, "Blood pressure decrease during the acute phase of ischemic stroke is associated with brain injury and poor stroke outcome" 35 : 520-526, 2004

33 Chamorro A, "Blood pressure and functional recovery in acute ischemic stroke" 29 : 1850-1853, 1998

34 Adams HP Jr, "Baseline NIH Stroke Scale score strongly predicts outcome after stroke: a report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST)" 53 : 126-131, 1999

35 Thygesen SK, "Atrial fibrillation in patients with ischemic stroke: a population-based study" 1 : 55-65, 2009

36 Wolf PA, "Atrial fibrillation as an independent risk factor for stroke: the Framingham Study" 22 : 983-988, 1991

37 Kaarisalo MM, "Atrial fibrillation and stroke. Mortality and causes of death after the first acute ischemic stroke" 28 : 311-315, 1997

38 Arnold M, "Age-dependent differences in demographics, risk factors, comorbidity, etiology, management, and clinical outcome of acute ischemic stroke" 255 : 1503-1507, 2008

39 Jørgensen HS, "Acute stroke with atrial fibrillation. The Copenhagen Stroke Study" 27 : 1765-1769, 1996

40 Arboix A, "Acute stroke in very old people: clinical features and predictors of inhospital mortality" 48 : 36-41, 2000

41 Olindo S, "Acute stroke in the very elderly: epidemiological features, stroke subtypes, management, and outcome in Martinique, French West Indies" 34 : 1593-1597, 2003

42 Fagan SC, "Acute hypertension promotes hemorrhagic transformation in a rabbit embolic stroke model: effect of labetalol" 150 : 153-158, 1998