Τίτλος:
Incidence, characteristics and outcomes in patients with embolic stroke of undetermined source: A population-based study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Embolic stroke of undetermined source (ESUS) represents a subgroup of cryptogenic ischemic stroke (CS) distinguished by high probability of an underlying embolic mechanism. There are scarce population-based data regarding the incidence, characteristics and outcomes of ESUS. Consecutive patients included with first-ever ischemic stroke of undetermined cause in the previously published population-based Evros Stroke Registry were further subdivided into ESUS and non-ESUS CS. Crude and adjusted [according to the European Standard Population (ESP), WHO and Segi population] incidence rates (IR) for ESUS and non-ESUS CS were calculated. Baseline characteristics, admission stroke severity (assessed using NIHSS-score), stroke recurrence and functional outcomes [determined by modified Rankin Scale (mRS) scores], were recorded during the 1-year follow-up period. We identified 21 and 242 cases with ESUS (8% of CS) and non-ESUS CS. The crude and ESP-adjusted IR for ESUS were 17.5 (95%CI: 10–25) and 16.6 (95%CI: 10–24) per 100,000 person-years. Patients with ESUS were younger (p <.001) and had lower median admission NIHSS-scores (p <.001). Functional outcomes were more favorable in ESUS at 28, 90 and 365 days. ESUS was independently (p =.033) associated with lower admission NIHSS-scores (unstandardized linear regression coefficient: -13.34;95%CI: -23.34, −3.35) on multiple linear regression models. ESUS was not related to 1-year stroke recurrence, mortality and functional improvement on multivariable analyses. In conclusion we found that ESUS cases represented 8% of CS patients in this population-based study. Despite the fact that ESUS was independently related to lower admission stroke severity, there was no association of ESUS with long-term outcomes. © 2019
Συγγραφείς:
Tsivgoulis, G.
Kargiotis, O.
Katsanos, A.H.
Patousi, A.
Mavridis, D.
Tsokani, S.
Pikilidou, M.
Birbilis, T.
Mantatzis, M.
Zompola, C.
Triantafyllou, S.
Papanas, N.
Skendros, P.
Terzoudi, A.
Georgiadis, G.S.
Maltezos, E.
Piperidou, C.
Tsioufis, K.
Heliopoulos, I.
Vadikolias, K.
Περιοδικό:
Journal of the Neurological Sciences
Λέξεις-κλειδιά:
adult; aged; Article; brain ischemia; cardiovascular disease; diastolic blood pressure; disease severity; embolic stroke of undetermined sour; female; follow up; human; hypertension; incidence; major clinical study; male; mortality; National Institutes of Health Stroke Scale; priority journal; Rankin scale; recurrent disease; risk factor; atrial fibrillation; cerebrovascular accident; cohort analysis; embolism; Greece; health survey; middle aged; procedures; register; treatment outcome; very elderly, Aged; Aged, 80 and over; Atrial Fibrillation; Cohort Studies; Embolism; Female; Follow-Up Studies; Greece; Humans; Incidence; Male; Middle Aged; Population Surveillance; Registries; Stroke; Treatment Outcome
DOI:
10.1016/j.jns.2019.04.008
