Yonsei Stroke Registry - Analysis of 1,000 patients with acute cerebral infarctions
Yonsei Stroke Registry - Analysis of 1,000 patients with acute cerebral infarctions
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DOI：
10.1159/000047697
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发表时间：
2001-01-01
影响因子：
2.9
通讯作者：
Kim, DI
中科院分区：
文献类型：
--
作者：
Lee, BI;Nam, HS;Kim, DI
背景和目的：以医院为基础的卒中登记是一种成熟的方法，有助于了解与地理、种族或环境差异有关的卒中的不同临床特征。我们分析了延世中风注册中心(YSR)登记的1000名急性脑梗塞患者的数据，这是韩国第一项基于医院的前瞻性观察性研究。方法：所有患者均为脑梗塞，发病7d内发病。所有患者均行CT或MRI检查，53.9%的患者行血管成像检查(数字减影或磁共振血管成像)。亚型分类是在严格应用Toast标准的基础上通过一致的方法进行的。结果：患者平均年龄为62+/-12岁，男性占60.8%。不明原因(UD)是最常见的亚型(40.6%)，其次是腔隙性卒中(21.5%)、心脏栓塞(18.3%)、大动脉粥样硬化(16.5%)和其他原因(3.1%)。高血压占64.3%，吸烟占35.2%，糖尿病占26.9%，高胆固醇血症占24.1%，高红细胞压积(大于或等于50%)占21.8%，临床确诊的潜在心脏栓塞源占18.3%，既往卒中病史占22.0%，短暂性脑缺血发作病史占4.7%。与首次卒中相比，再发卒中与更多的危险因素相关(p<；0.001)和更高的左旋心衰发生率(p=0.003)。椎基底动脉区域梗死率为39.8%，与颈动脉区域病变相比，椎基底动脉区域病变的发生率较高(p=0.001)，颈动脉病变的发生率较低。30d死亡率为5.3%，脑突出症早期死亡率为52%。结论：卒中亚型在YSR中的分布与西方文献中的分布基本一致。UD的发生率最高可能与严格应用Toast标准有关。版权所有(C)2001 S.KargerAG，巴塞尔。
Background and Purpose: The hospital-based stroke registry is a well-established method useful for understanding diverse clinical characteristics of stroke related to geographical, racial or environmental differences. We analyzed the data from 1,000 patients with acute cerebral infarctions registered with the Yonsei Stroke Registry (YSR) which is the first prospective hospital-based observational study in Korea. Methods: All patients had cerebral infarctions and presented within 7 days of onset. CT or MRI was performed in all patients and a vascular imaging study (digital subtraction or magnetic resonance angiography) was conducted in 53.9% of the patients. Subtype classification was made through a consensus approach based on the strict application of TOAST criteria. Results: The mean age of patients was 62 +/- 12 years, and 60.8% were males. Undetermined cause (UD) was the most frequent subtype (40.6%), which was followed by lacunar stroke (LS 21.5%), cardiac embolism (CE 18.3%), large-artery atherosclerosis (LAA 16.5%) and other determined causes (3.1%). Hypertension was found in 64.3%, smoking in 35.2%, diabetes mellitus in 26.9%, hypercholesterolemia in 24.1%, high hematocrit (greater than or equal to 50%) in 21.8%, clinically identified potential cardiac sources of embolism in 18.3%, a history of previous stroke in 22.0% and a history of previous transient ischemic attack in 4.7%. Recurrent stroke was associated with a higher number of risk factors (p < 0.001) and a higher incidence of LAA (p = 0.003) than the first stroke. Vertebrobasilar artery territorial infarction was found in 39.8%, which was associated with higher incidences of LAA and LS and a lower incidence of CE than carotid artery territorial lesions (p = 0.001). The 30-day mortality rate was 5.3% and cerebral herniation caused early death in 52%. Conclusion: The distribution of stroke subtypes in the YSR was largely comparable with that of western registries. The highest incidence of UD might be related to the strict application of TOAST criteria. Copyright (C) 2001 S. KargerAG, Basel.