Severity and outcomes according to stroke etiology in patients under 50 years of age with ischemic stroke

被引:10
作者
Prefasi, Daniel [1 ,2 ]
Martinez-Sanchez, Patricia [1 ,2 ]
Fuentes, Blanca [1 ,2 ]
Diez-Tejedor, Exuperio [1 ,2 ]
机构
[1] Autonomous Univ Madrid, La Paz Univ Hosp, IdiPAZ Hlth Res Inst, Dept Neurol, Paseo Castellana 261, Madrid 28046, Spain
[2] Autonomous Univ Madrid, La Paz Univ Hosp, IdiPAZ Hlth Res Inst, Stroke Ctr, Paseo Castellana 261, Madrid 28046, Spain
关键词
Stroke; Stroke in young adults; Stroke severity; Stroke outcomes; Stroke etiology; CERVICAL ARTERY DISSECTION; LONG-TERM PROGNOSIS; YOUNG-ADULTS; RISK-FACTORS; ATRIAL-FIBRILLATION; LACUNAR INFARCTION; CAROTID DISSECTION; NATURAL-HISTORY; RECURRENCE; SUBTYPES;
D O I
10.1007/s11239-016-1336-5
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
To analyze the association of stroke etiological subtypes with severity and outcomes at 3 and 12 months in patients a parts per thousand currency sign50 years. Observational study of patients admitted to a stroke unit (2007-2013). Variables: demographic data, vascular risk factors, comorbidities, severity on admission (NIHSS), and good functional outcome (mRS a parts per thousand currency sign 1) at 3 and 12 months. We used multivariate analyses to evaluate the influence of stroke etiology on severity and outcomes. We included 214 patients, 58.3 % men, mean age 41.4 years. General linear models showed all etiologies were more severe than lacunar strokes (P < 0.05). Atherothrombotic strokes showed greater severity than those of undetermined and uncommon etiology, whereas cardioembolic strokes were more severe than cryptogenic. Taking into account specific etiologies, atherothrombotic strokes (B = 5.860; 95 % CI 2.979-8.751), cervical artery dissection (CAD) [B = 7.485; 95 % confidence interval (CI) 4.734-10.237], and atrial fibrillation (AF) strokes (B = 5.773; 95 % CI 2.704-8.132) were more severe than other etiologies. Logistic regression models showed that strokes of uncommon etiology, especially those not related to CAD, had a lower probability of good outcome at 3 months [odds ratio (OR) = 0.197; CI 95 % 0.044-0.873], whereas atherothrombotic strokes were associated with this probability at 12 months (OR = 0.187; 95 % CI 0.037-0.951; P = 0.007). In patients a parts per thousand currency sign50 years of age, strokes of atherothrombotic, cardioembolic (particularly those due to AF), and uncommon etiology had a greater severity than the rest. Furthermore, strokes of uncommon etiology, especially those different from CAD, decreased the probability of a good outcome at 3 months, as did atherothrombotic strokes at 1 year.
引用
收藏
页码:272 / 282
页数:11
相关论文
共 37 条
  • [1] Arboix A, 1998, Neurologia, V13 Suppl 3, P3
  • [2] CLASSIFICATION AND NATURAL-HISTORY OF CLINICALLY IDENTIFIABLE SUBTYPES OF CEREBRAL INFARCTION
    BAMFORD, J
    SANDERCOCK, P
    DENNIS, M
    BURN, J
    WARLOW, C
    [J]. LANCET, 1991, 337 (8756) : 1521 - 1526
  • [3] Cervical cerebral artery dissection: a multicenter prospective study (preliminary report)
    Bassi, P
    Lattuada, P
    Gomitoni, A
    [J]. NEUROLOGICAL SCIENCES, 2003, 24 (Suppl 1) : S4 - S7
  • [4] Stroke recurrence in patients with patent foramen ovale: The Lausanne Study
    Bogousslavsky, J
    Garazi, S
    Jeanrenaud, X
    Aebischer, N
    VanMelle, G
    [J]. NEUROLOGY, 1996, 46 (05) : 1301 - 1305
  • [5] SPONTANEOUS CAROTID DISSECTION WITH ACUTE STROKE
    BOGOUSSLAVSKY, J
    DESPLAND, PA
    REGLI, F
    [J]. ARCHIVES OF NEUROLOGY, 1987, 44 (02) : 137 - 140
  • [6] THE LAUSANNE STROKE REGISTRY - ANALYSIS OF 1,000 CONSECUTIVE PATIENTS WITH 1ST STROKE
    BOGOUSSLAVSKY, J
    VANMELLE, G
    REGLI, F
    [J]. STROKE, 1988, 19 (09) : 1083 - 1092
  • [7] LONG-TERM PROGNOSIS OF SYMPTOMATIC LACUNAR INFARCTS - A HOSPITAL-BASED STUDY
    CLAVIER, I
    HOMMEL, M
    BESSON, G
    NOELLE, B
    PERRET, JEF
    [J]. STROKE, 1994, 25 (10) : 2005 - 2009
  • [8] Cervical-artery dissections: predisposing factors, diagnosis, and outcome
    Debette, Stephanie
    Leys, Didier
    [J]. LANCET NEUROLOGY, 2009, 8 (07) : 668 - 678
  • [9] Classification of the cerebrovascular diseases.: Iberoamerican Cerebrovascular Diseases Society
    Díez-Tejedor, E
    Del Brutto, O
    Alvarez-Sabín, J
    Muñoz, M
    Abiusi, G
    [J]. REVISTA DE NEUROLOGIA, 2001, 33 (05) : 455 - 464
  • [10] Cervical artery dissection -: clinical features, risk factors, therapy and outcome in 126 patients
    Dziewas, R
    Konrad, C
    Dräger, B
    Evers, S
    Besselmann, M
    Lüdemann, P
    Kuhlenbäumer, G
    Stögbauer, F
    Ringelstein, EB
    [J]. JOURNAL OF NEUROLOGY, 2003, 250 (10) : 1179 - 1184