Long-term mortality according to the characteristics of early neurological deterioration in ischemic stroke patients

Young Dae Kim, Dongbeom Song, Eun Hye Kim, Ki Jeong Lee, Hye Sun Lee, Chung Mo Nam, Hyo Suk Nam, Jihoe Heo

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose: Although early neurological deterioration (END) during the acute stroke period is known to be associated with poor functional outcomes, there is little data regarding the impact of END on long-term outcomes according to the characteristics of END. The aim of this study was to investigate whether there are differences in long-term mortality according to the characteristics of END among acute ischemic stroke or transient ischemic attack patients. Materials and Methods: END was defined as any increase (≥1) in National Institute of Health Stroke Scale score within 7 days after admission. We assessed the characteristics of END, such as the etiology and severity of END, as well as recovery after END. The relationship between 30-day or long-term mortality and each characteristic of END was investigated using multiple logistic analysis or Cox regression model. Results: Among 2820 patients, END was observed in 344 patients (12.2%). After adjustment for age, sex, underlying cardiovascular diseases, stroke severity, and stroke subtypes, END was associated with long-term mortality, whether it was mild or severe and whether or not it was followed by recovery. However, 30-day mortality was strongly related to the severity of END or the absence of recovery after END. Among the causes of END, recurrent stroke and medical illness were related to 30-day mortality, as well as long-term mortality, while brain herniation and intracranial hemorrhagic complications were only associated with 30-day mortality. Conclusion: The results of the present study demonstrated that END is associated with higher mortality and the effects of END on short-term and long-term mortality depend on END characteristics.

Original languageEnglish
Pages (from-to)669-675
Number of pages7
JournalYonsei medical journal
Volume55
Issue number3
DOIs
Publication statusPublished - 2014 Jan 1

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Stroke
Mortality
Transient Ischemic Attack
National Institutes of Health (U.S.)
Proportional Hazards Models
Cardiovascular Diseases
Myocardial Infarction
Brain

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Kim, Young Dae ; Song, Dongbeom ; Kim, Eun Hye ; Lee, Ki Jeong ; Lee, Hye Sun ; Nam, Chung Mo ; Nam, Hyo Suk ; Heo, Jihoe. / Long-term mortality according to the characteristics of early neurological deterioration in ischemic stroke patients. In: Yonsei medical journal. 2014 ; Vol. 55, No. 3. pp. 669-675.
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abstract = "Purpose: Although early neurological deterioration (END) during the acute stroke period is known to be associated with poor functional outcomes, there is little data regarding the impact of END on long-term outcomes according to the characteristics of END. The aim of this study was to investigate whether there are differences in long-term mortality according to the characteristics of END among acute ischemic stroke or transient ischemic attack patients. Materials and Methods: END was defined as any increase (≥1) in National Institute of Health Stroke Scale score within 7 days after admission. We assessed the characteristics of END, such as the etiology and severity of END, as well as recovery after END. The relationship between 30-day or long-term mortality and each characteristic of END was investigated using multiple logistic analysis or Cox regression model. Results: Among 2820 patients, END was observed in 344 patients (12.2{\%}). After adjustment for age, sex, underlying cardiovascular diseases, stroke severity, and stroke subtypes, END was associated with long-term mortality, whether it was mild or severe and whether or not it was followed by recovery. However, 30-day mortality was strongly related to the severity of END or the absence of recovery after END. Among the causes of END, recurrent stroke and medical illness were related to 30-day mortality, as well as long-term mortality, while brain herniation and intracranial hemorrhagic complications were only associated with 30-day mortality. Conclusion: The results of the present study demonstrated that END is associated with higher mortality and the effects of END on short-term and long-term mortality depend on END characteristics.",
author = "Kim, {Young Dae} and Dongbeom Song and Kim, {Eun Hye} and Lee, {Ki Jeong} and Lee, {Hye Sun} and Nam, {Chung Mo} and Nam, {Hyo Suk} and Jihoe Heo",
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Long-term mortality according to the characteristics of early neurological deterioration in ischemic stroke patients. / Kim, Young Dae; Song, Dongbeom; Kim, Eun Hye; Lee, Ki Jeong; Lee, Hye Sun; Nam, Chung Mo; Nam, Hyo Suk; Heo, Jihoe.

In: Yonsei medical journal, Vol. 55, No. 3, 01.01.2014, p. 669-675.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term mortality according to the characteristics of early neurological deterioration in ischemic stroke patients

AU - Kim, Young Dae

AU - Song, Dongbeom

AU - Kim, Eun Hye

AU - Lee, Ki Jeong

AU - Lee, Hye Sun

AU - Nam, Chung Mo

AU - Nam, Hyo Suk

AU - Heo, Jihoe

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Purpose: Although early neurological deterioration (END) during the acute stroke period is known to be associated with poor functional outcomes, there is little data regarding the impact of END on long-term outcomes according to the characteristics of END. The aim of this study was to investigate whether there are differences in long-term mortality according to the characteristics of END among acute ischemic stroke or transient ischemic attack patients. Materials and Methods: END was defined as any increase (≥1) in National Institute of Health Stroke Scale score within 7 days after admission. We assessed the characteristics of END, such as the etiology and severity of END, as well as recovery after END. The relationship between 30-day or long-term mortality and each characteristic of END was investigated using multiple logistic analysis or Cox regression model. Results: Among 2820 patients, END was observed in 344 patients (12.2%). After adjustment for age, sex, underlying cardiovascular diseases, stroke severity, and stroke subtypes, END was associated with long-term mortality, whether it was mild or severe and whether or not it was followed by recovery. However, 30-day mortality was strongly related to the severity of END or the absence of recovery after END. Among the causes of END, recurrent stroke and medical illness were related to 30-day mortality, as well as long-term mortality, while brain herniation and intracranial hemorrhagic complications were only associated with 30-day mortality. Conclusion: The results of the present study demonstrated that END is associated with higher mortality and the effects of END on short-term and long-term mortality depend on END characteristics.

AB - Purpose: Although early neurological deterioration (END) during the acute stroke period is known to be associated with poor functional outcomes, there is little data regarding the impact of END on long-term outcomes according to the characteristics of END. The aim of this study was to investigate whether there are differences in long-term mortality according to the characteristics of END among acute ischemic stroke or transient ischemic attack patients. Materials and Methods: END was defined as any increase (≥1) in National Institute of Health Stroke Scale score within 7 days after admission. We assessed the characteristics of END, such as the etiology and severity of END, as well as recovery after END. The relationship between 30-day or long-term mortality and each characteristic of END was investigated using multiple logistic analysis or Cox regression model. Results: Among 2820 patients, END was observed in 344 patients (12.2%). After adjustment for age, sex, underlying cardiovascular diseases, stroke severity, and stroke subtypes, END was associated with long-term mortality, whether it was mild or severe and whether or not it was followed by recovery. However, 30-day mortality was strongly related to the severity of END or the absence of recovery after END. Among the causes of END, recurrent stroke and medical illness were related to 30-day mortality, as well as long-term mortality, while brain herniation and intracranial hemorrhagic complications were only associated with 30-day mortality. Conclusion: The results of the present study demonstrated that END is associated with higher mortality and the effects of END on short-term and long-term mortality depend on END characteristics.

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EP - 675

JO - Yonsei Medical Journal

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SN - 0513-5796

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