Objective To assess predictive clinical factors of cardioembolic infarction in very old patients(85 years of age and older).Methods Prospective hospital-based stroke registry("The Sagrat Cor Hospital of Barcelona...Objective To assess predictive clinical factors of cardioembolic infarction in very old patients(85 years of age and older).Methods Prospective hospital-based stroke registry("The Sagrat Cor Hospital of Barcelona Stroke Registry")is an acute-care teaching hospital in Barcelona,Catalonia,Spain.From 956 first-ever cardioembolic stroke patients included in the stroke registry over a 24-year period,639 were younger than 85 years of age and 317 were 85 years or older(mean age:88.9 years).Demographics,clinical characteristics,risk factors and early outcome were compared.Predictors of cardioembolic infarction in the oldest age group were assessed by multivariate analyses.Results In a logistic regression model based on demographics,risk factors,clinical features and complications,female gender(odds ratio[OR]=1.74,95%confidence interval[CI]:1.27–2.39),heart failure(OR=2.27,95%CI:1.46–3.56),altered consciousness(OR=1.76,95%CI:1.28–2.42),and infectious complications(OR=2.01,95%CI:1.39–2.91)were predictors of cardioembolic stroke in the oldest age group.By contrast,heavy smoking,heart valve disease,hypertension,headache,early seizures,sensory deficit,and involvement of the posterior cerebral artery were independently associated with cardioembolic stroke in the younger group.Conclusions Identification of a differential clinical profile of cardioembolic stroke between patients aged 85 years or more and those younger than 85 years helps clinicians to the optimal management of ischemic infarction in the oldest segment of the population.展开更多
目的探讨安阳地区青年脑梗死（cerebral infarction,CI）的临床特征、危险因素及病因。方法收集长期居住于安阳地区的148例首发急性青年CI患者为研究对象,依据年龄分为18～25岁组、26～35岁组和36～45岁组,各组患者按照急性卒中治疗低...目的探讨安阳地区青年脑梗死（cerebral infarction,CI）的临床特征、危险因素及病因。方法收集长期居住于安阳地区的148例首发急性青年CI患者为研究对象,依据年龄分为18～25岁组、26～35岁组和36～45岁组,各组患者按照急性卒中治疗低分子肝素试验（Trial of Org 10172 in Acute Stroke Treatment,TOAST）方法进行病因分型,同时记录每例患者的基本资料以及合并的危险因素。结果 148例青年CI患者中男性（81.8%）多于女性（18.2%）,农村患者（56.8%）多于城市患者（43.2%）。常见可干预危险因素暴露率以高同型半胱氨酸血症最高（58.1%）,其次为高血压病（54.7%）、高脂血症（45.9%）、大量吸烟（30.4%）、大量饮酒（17.6%）、糖尿病（10.8%）。各年龄组间合并高血压病（P=0.008）、大量吸烟（P=0.031）发生率差异有显著性,且均以36～45岁组最高。TOAST分型中大动脉粥样硬化型（large artery atherosclerosis,LAA）62例（41.9%）、不明原因型（stroke of undetermined etiology,SUE）48例（32.4%）、小动脉闭塞型（small artery occlusion,SAO）20例（13.5%）、其他明确病因型（stroke of other determined etiology,SDE）14例（9.5%）、心源性栓塞型（cardioembolism,CE）4例（2.7%）。各病因组间合并糖尿病（P=0.014）、高脂血症（P=0.030）发生率差异有显著性,且均以SAO组最高。不同年龄组患者TOAST分型构成不同：18～25岁组以SDE构成比最高（60.0%）,其次为SUE（40.0%）;26～35岁组以LAA、SUE构成比最高（均为31.8%）;36～45岁组以LAA构成比最高（45.5%）,SUE次之（32.2%）。结论安阳地区青年CI患者的性别和城乡构成差异明显。危险因素以高同型半胱氨酸血症最为常见,其次为高血压病、高脂血症和大量吸烟。36～45岁患者合并高血压病、大量吸烟明显增多。TOAST病因分型以LAA和SUE为主,并且合并不同危险因素患者发病病因不尽相同。展开更多
文摘Objective To assess predictive clinical factors of cardioembolic infarction in very old patients(85 years of age and older).Methods Prospective hospital-based stroke registry("The Sagrat Cor Hospital of Barcelona Stroke Registry")is an acute-care teaching hospital in Barcelona,Catalonia,Spain.From 956 first-ever cardioembolic stroke patients included in the stroke registry over a 24-year period,639 were younger than 85 years of age and 317 were 85 years or older(mean age:88.9 years).Demographics,clinical characteristics,risk factors and early outcome were compared.Predictors of cardioembolic infarction in the oldest age group were assessed by multivariate analyses.Results In a logistic regression model based on demographics,risk factors,clinical features and complications,female gender(odds ratio[OR]=1.74,95%confidence interval[CI]:1.27–2.39),heart failure(OR=2.27,95%CI:1.46–3.56),altered consciousness(OR=1.76,95%CI:1.28–2.42),and infectious complications(OR=2.01,95%CI:1.39–2.91)were predictors of cardioembolic stroke in the oldest age group.By contrast,heavy smoking,heart valve disease,hypertension,headache,early seizures,sensory deficit,and involvement of the posterior cerebral artery were independently associated with cardioembolic stroke in the younger group.Conclusions Identification of a differential clinical profile of cardioembolic stroke between patients aged 85 years or more and those younger than 85 years helps clinicians to the optimal management of ischemic infarction in the oldest segment of the population.
文摘目的探讨安阳地区青年脑梗死（cerebral infarction,CI）的临床特征、危险因素及病因。方法收集长期居住于安阳地区的148例首发急性青年CI患者为研究对象,依据年龄分为18～25岁组、26～35岁组和36～45岁组,各组患者按照急性卒中治疗低分子肝素试验（Trial of Org 10172 in Acute Stroke Treatment,TOAST）方法进行病因分型,同时记录每例患者的基本资料以及合并的危险因素。结果 148例青年CI患者中男性（81.8%）多于女性（18.2%）,农村患者（56.8%）多于城市患者（43.2%）。常见可干预危险因素暴露率以高同型半胱氨酸血症最高（58.1%）,其次为高血压病（54.7%）、高脂血症（45.9%）、大量吸烟（30.4%）、大量饮酒（17.6%）、糖尿病（10.8%）。各年龄组间合并高血压病（P=0.008）、大量吸烟（P=0.031）发生率差异有显著性,且均以36～45岁组最高。TOAST分型中大动脉粥样硬化型（large artery atherosclerosis,LAA）62例（41.9%）、不明原因型（stroke of undetermined etiology,SUE）48例（32.4%）、小动脉闭塞型（small artery occlusion,SAO）20例（13.5%）、其他明确病因型（stroke of other determined etiology,SDE）14例（9.5%）、心源性栓塞型（cardioembolism,CE）4例（2.7%）。各病因组间合并糖尿病（P=0.014）、高脂血症（P=0.030）发生率差异有显著性,且均以SAO组最高。不同年龄组患者TOAST分型构成不同：18～25岁组以SDE构成比最高（60.0%）,其次为SUE（40.0%）;26～35岁组以LAA、SUE构成比最高（均为31.8%）;36～45岁组以LAA构成比最高（45.5%）,SUE次之（32.2%）。结论安阳地区青年CI患者的性别和城乡构成差异明显。危险因素以高同型半胱氨酸血症最为常见,其次为高血压病、高脂血症和大量吸烟。36～45岁患者合并高血压病、大量吸烟明显增多。TOAST病因分型以LAA和SUE为主,并且合并不同危险因素患者发病病因不尽相同。
