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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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Background and Purpose Early neurologic deterioration (END) occurs in up to one-third of patients with ischemic stroke and is associated with poor outcomes. The purpose of the present study was to determine which stroke etiologies and vascular distributions pose a greater threat of END in stroke patients.
Methods Using a single-center registry of prospectively maintained clinical data, adult ischemic stroke patients admitted (July 2008 to June 2014) within 48 hours of symptom onset were evaluated according to stroke etiology and vascular distribution using diffusion-weighted MRI. Major stroke etiologies were divided into cardioembolic, large vessel, small vessel, other, unknown source, and multiple possible etiologies. END was defined as a worsening of 2 or more points on the National Institutes of Health Stroke Scale during a 24-hour period of hospitalization. Crude and backward stepwise regression models were generated to associate stroke etiology and vascular distribution with END.
Results Of the included 961 patients (median age 65 years, 47% female, 72% non-White), 323 (34%) experienced END. Strokes involving the internal carotid artery (ICA) were associated with a threefold higher odds of END in stepwise regression models (OR 3.0, 95% CI 1.4-6.6, P= 0.006).
Among stroke etiologies, those with unclear mechanisms had the lowest odds of END in the fully adjusted model (OR 0.6, 95% CI 0.4-1.0, P= 0.029).
Conclusions In our single-center cohort of patients, ICA infarctions were independently associated with END whereas strokes of unknown etiology were least often associated with END. Larger cohorts are necessary to determine which steps, if any, can be taken to prevent END in these vulnerable populations.
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참고문헌 (32)
참고문헌 신청
Siegler JE / 2011 / Early Neurological Deterioration(END)after stroke : the END depends on the definition / Int J Stroke 6:211~212
Adams HP Jr / 1999 / Baseline NIH Stroke Scale score strongly predicts outcome after stroke : a report of the Trial of Org 10172 in Acute Stroke Treatment(TOAST) / Neurology 53:126~131
Weimar C / 2005 / Neurologic worsening during the acute phase of ischemic stroke / Arch Neurol 62:393~397
Castillo J / 2004 / Blood pressure decrease during the acute phase of ischemic stroke is associated with brain injury and poor stroke outcome / Stroke 35:520~526
Kwan J / 2006 / Early neurological deterioration in acute stroke : clinical characteristics and impact on outcome / QJM 99:625~633
Adams HP Jr / 1999 / Baseline NIH Stroke Scale score strongly predicts outcome after stroke : a report of the Trial of Org 10172 in Acute Stroke Treatment(TOAST) / Neurology 53:126~131
Weimar C / 2005 / Neurologic worsening during the acute phase of ischemic stroke / Arch Neurol 62:393~397
Castillo J / 2004 / Blood pressure decrease during the acute phase of ischemic stroke is associated with brain injury and poor stroke outcome / Stroke 35:520~526
Kwan J / 2006 / Early neurological deterioration in acute stroke : clinical characteristics and impact on outcome / QJM 99:625~633
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