PROGNOSIS OF YOUNG-ADULTS WITH ISCHEMIC STROKE - A LONG-TERM FOLLOW-UP-STUDY ASSESSING RECURRENT VASCULAR EVENTS AND FUNCTIONAL OUTCOME IN THE IOWA REGISTRY OF STROKE IN YOUNG-ADULTS
PROGNOSIS OF YOUNG-ADULTS WITH ISCHEMIC STROKE - A LONG-TERM FOLLOW-UP-STUDY ASSESSING RECURRENT VASCULAR EVENTS AND FUNCTIONAL OUTCOME IN THE IOWA REGISTRY OF STROKE IN YOUNG-ADULTS
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DOI：
10.1161/01.str.25.7.1360
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发表时间：
1994-07-01
期刊：
影响因子：
8.3
通讯作者：
BILLER, J
中科院分区：
文献类型：
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作者：
KAPPELLE, LJ;ADAMS, HP;BILLER, J
背景和目的关于年轻缺血性卒中患者长期预后的信息有限。因此，我们对爱荷华州青年卒中登记处登记的296例缺血性卒中患者进行了随访评估。我们研究了1977年7月1日至1992年1月1日期间转诊到三级医疗中心治疗缺血性卒中的年轻人（年龄15至45岁）。方法通过问卷调查、检查、电话访谈、回顾病历和私人医生报告进行随访评估。收集有关危险因素、并发内科疾病、卒中病因、治疗、复发性卒中、其他血管事件和死亡的数据。采用格拉斯哥结局量表、Barthel指数、国立卫生研究院卒中量表和简易精神状态检查量表对结局进行评定。生活质量进行了评估与SF-36健康状况questionnaire.Results随访信息的状态10例是有限的，除了他们都活着。21名患者（7%）因首次中风死亡，另有40名患者（14%）在平均6.0年的随访期间死亡。卒中时年龄在25岁或以下的患者在随访期间均未死亡。继发于大血管卒中的卒中患者的死亡率显著较高，病因不明的卒中患者的死亡率显著低于其他原因卒中患者（相对风险[RR]，1.7; 95%置信限[CL]，1.0 - 2.7; RR，0.1; CL，0 - 0.6;分别）。23例患者（9%）发生复发性卒中，其中9例患者死亡。另外37名患者在随访期间接受了心脏病专家的治疗; 3名患者发生了心肌梗死。另有14名患者需要进行大血管手术。格拉斯哥结局量表和Barthel指数的结局总体良好。尽管如此，只有49%的患者仍然活着，没有残疾，没有复发的血管事件，或者没有接受过大血管手术。只有42%的幸存者重返工作岗位。大多数的幸存者报告的情绪，社会，或身体的残留物，减少了quality of life.Conclusions复发性血管事件的风险在年轻人谁有缺血性中风是相当大的。此外，大多数幸存者将存在残余的情感、社交或身体障碍，从而阻碍就业或降低生活质量。需要进一步研究中风幸存的年轻人的生活质量。
Background and Purpose Information about the long-term prognosis of young adults with ischemic stroke is limited. Therefore, we performed a follow-up assessment of 296 patients with ischemic stroke who are enrolled in the Iowa Registry of Stroke in Young Adults. We studied young adults (age, 15 to 45 years) who were referred to a tertiary medical center for management of ischemic stroke between July 1, 1977, and January 1, 1992.Methods Follow-up assessments were performed by means of questionnaires, examinations, telephone interviews, review of medical records, and reports from personal physicians. Data about risk factors, coincident medical diseases, etiology of stroke, treatment, recurrent stroke, other vascular events, and deaths were collected. Outcomes were rated with the Glasgow Outcome Scale, Barthel Index, National Institutes of Health stroke scale, and the Mini-Mental State Examination. Quality of life was assessed with the SF-36 Health Status questionnaire.Results Follow-up information about the status of 10 patients was limited except that they were alive. Twenty-one patients (7%) died as the result of their initial stroke, and another 40 patients (14%) died during a mean follow-up of 6.0 years. None of the patients aged 25 years or younger at the time of stroke died during follow-up. Mortality was significantly higher among patients who had a stroke secondary to large-vessel stroke and it was significantly lower in patients with stroke of unknown etiology than in patients with stroke of other causes (relative risk [RR], 1.7; 95% confidence limits [CL], 1.0 to 2.7; and RR, 0.1; CL, 0 to 0.6; respectively). Recurrent strokes occurred in 23 patients (9%) and were fatal in 9. Another 37 patients were treated by a cardiologist during follow-up; 3 had had a myocardial infarct. Fourteen additional patients needed major vascular surgery. Outcomes with the Glasgow Outcome Scale and Barthel Index were generally favorable. Still, only 49% of patients were still alive, were not disabled, had not suffered from recurrent vascular events, or had not undergone major vascular surgery. Only 42% of survivors had returned to work. A majority of survivors reported emotional, social, or physical residuals that lessened the quality of life.Conclusions The risks of recurrent vascular events in young adults who have had ischemic stroke are considerable. In addition, a majority of survivors will have residual emotional, social, or physical impairments that hamper employment or lower the quality of life. Further research on the quality of life for young adults who survive stroke is needed.