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ノウコウソク ノ チリョウ セイセキ ワ ナゼ コウジョウ シナイ ノカ : 10ネンカン ノ ヤマガタケン ノウソッチュウ トウロク データ カラ ノ ヨゴ フリョウ インシ ノ ケントウ

By Yamada Yuki, Kokubo Yasuaki, Kondo Rei, Sato Shinya, Kato Takeo, Kubota Isao, Watanabe Masafumi, Kayama Takamasa and Sonoda Yukihiko

Abstract

 We studied ten years of stroke data registered with the Yamagata Society on Treatment for Cerebral Stroke(YSTCS). The subjects included 16,407 cases of acute-phase cerebral infarction that were registered with the YSTCS during the ten years between 2002 and 2011. The cases were divided into two groups: the early phase group(2002-2006)and the late phase group(2007-2011). The clinical diagnoses included atherothrombotic cerebral infarction(AT)(n=7,196; 43.9%), cardiogenic cerebral embolism(CE)(n=4,011; 24.4%), and lacunar infarction(LI)(n=4,703; 28.7%). The average age of the early phase group was 72.7±11.43 years, while that of the late phase group was 75.0±11.35 years; the difference was statistically significant. The proportion of CE cases increased in the late phase, while that of LI decreased. This phenomenon was more marked in cases involving patients of ≥80 years of age. In both the early and late phase groups, the AT and CE cases showed a significantly high proportion of poor outcomes. However, when age adjustment was implemented in the late phase group, the treatment outcomes improved across all clinical entities. A multiple logistic regression analysis revealed a significant association between old age, female sex, severe symptoms at onset, CE, a previous history of stroke, and a poor prognosis. It is clear that developments in medicine have not kept pace with the advancement in the age at onset. The improvement of the outcomes of treatment for cerebral infarction requires further developments in acute-phase therapies and the primary prevention of cardiogenic cerebral embolism, many cases of which are severe

Publisher: 山形大学
Year: 2018
OAI identifier: oai:yamagata.repo.nii.ac.jp:00004477
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