Correlation betw een the etiologic subtype and outcome in patients w ith non -disabling ischemic cerebrovascular events
10.3760/cma.j.issn.1673-4165.2016.11.004
- VernacularTitle:非致残性缺血性脑血管事件患者的病因学分型与转归的相关性
- Author:
Chang CHAI
;
Quanzhong HU
- Keywords:
Stroke;
BrainIschemia;
SeverityofIlnessIndex;
IschemicAttack,Transient;
Treatment Outcome;
Recurrence;
Risk Factors
- From:
International Journal of Cerebrovascular Diseases
2016;24(11):998-1003
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveToinvestigatethecorrelationbetweentheetiologicsubtypeandoutcomein patients w ith non-disabling ischemic cerebrovascular events (NICE). Methods The consecutive patients w ith NICE admitted to hospital within 7 days after onset were enroled prospectively and folowed for 90 days. Etiologic subtypes w ere classified according to the Chinese Ischemic Stroke Subclassification (CISS). Good outcome w as defined as modified Rankin Scale score 0-2. Multivariate logistic regression analysis w as used to identify the independent risk factors for stroke recurrence and poor outcomes. Results A total of 162 patients with NICE were enroled. According to CISS, 76 (46.9%) were classified into large artery atherosclerosis (LAA), 54 (33.3%) into penetrating artery disease (PAD), 15 (9.3%) into cardiogenic stroke (CS), 11 (6.8%) into undetermined etiology (UE), and 6 (3.7%) into other etiology (OE). A total of 30 patients (18.5%) had recurrent stroke w ithin 90 days and 42 (25.9%) had poor outcomes. The proportions of patients w ith diabetes (46.7%vs.20.5%;χ2 =8.885, P=0.003), previous stroke or transient ischemic attack (46.7%vs.25.0%;χ2 =5.572, P=0.018), CS (20.0%vs.6.8%;Fisher exact test:P=0.036) in the stroke recurrence group w ere significantly higher than those in the non-stroke recurrence group, and the proportion of PAD patients in the stroke recurrence group w as significantly low er than that in the non -stroke recurrence group ( 16.7%vs.37.1%; χ2 =4.602, P=0.032 ). Multivariate logistic regression analysis show ed that diabetes (odds ratio [OR] 2.137, 95%confidence interval [CI] 1.359-4.187;P=0.004) and CS (OR 5.236, 95%CI 2.326-10.256; P<0.001) w ere the independent risk factors for recurrent stroke of NICE. The proportions of patients w ith hypertension ( 83.3%vs.61.7%; χ2 =6.635, P=0.010 ), diabetes (40.5%vs.20.0%;χ2 =6.900, P=0.009), atrial fibrilation (35.7%vs.14.2%;χ2 =9.113, P=0.003) and CS ( 19.0%vs.5.8%; Fisher exact test: P= 0.017 ) in the poor outcome group w ere significantly higher than those in the good outcome group, and the proportion of PAD patients ( 16.7%vs. 39.2%;χ2 =7.088, P=0.008) in the poor outcome group w as significantly low er than that in the good outcome group. Multivariate logistic regression analysis show ed that diabetes ( OR 2.257, 95%CI 1.209-3.687; P=0.010), atrial fibrilation (OR 3.137, 95%CI 1.359-6.107, P=0.002), and CS (OR 6.123, 95%CI 2.026-12.256, P<0.001) w ere the independent risk factors for poor outcomes in patient w ith NICE. Conclusions The etiologic subtype is associated w ith the poor outcomes and recurrent stroke, and can provide reference for recurrence and clinical outcome assessment in patients w ith NICE.
