DOI: https://doi.org/10.22141/2224-0713.8.94.2017.120698

Prediction of the outcome of an acute period of recurrent cerebral ischemic hemispheric stroke

L.V. Novikova

Abstract


Background. The purpose of this work was to predict the outcome of an acute period of reсcurrent cerebral ischemic hemispheric stroke by creating mathematical models based on a combined clinical and paraclinical examinations of the patients. Materials and methods. The comparative, cohort, prospective, open-label study, which included 66 patients aged 50 to 80 years with recurrent cerebral ischemic hemispheric stroke, was performed. Patients with a hemorrhagic or mixed type of recurrent stroke admitted to the hospital within more than 24 hours from the first signs of stroke; individuals with concomitant somatic pathology in the stage of decompensation, uncontrolled hypertension, anamnestic data about craniocerebral trauma, alcohol addiction were not included in the study. Patients which had total score by National Institutes of Health Stroke Scale (NIHSS) less than 5 and more than 20 were also excluded from the study. The lethal and non-lethal outcomes were main endpoints determining assignment of patients in the observation group. The main group consisted of 41 (62.1 %) patients who had a favorable outcome for life and the control group included 25 (37.9 %) patients with a fatal stroke. The details of the disease history, risk factors, somatic pathology, level of recovery after the first stroke (evaluated by modified Rankin Scale) were studied. The assessment of stroke severity was performed by NIHSS. Computed tomography of the brain was performed using the multislice computer tomograph Siemens Somatom Spirit, clinical, biochemical and laboratory tests, paraclinical examinations were carried out. Results. We have established that atrial fibrillation, diabetes mellitus, heart failure, myocardial infarction in the past and arterial hypertension over 20 years were the main predictors of patients’ death. Conclusions. The volume and location of the recurrent focus of cerebral ischemia, the volume and lateralization of the cyst (after first stroke), coagulogram, blood analysis and glycemic profile were predictors of lethal outcome among patients with stroke.


Keywords


recurrent cerebral ischemic hemispheric stroke; prediction; favorable and unfavorable outcome

References


Козелкин А.А., Новикова Л.В. Клинико-неврологические особенности и динамика когнитивных расстройств у больных в острый период повторного мозгового ишемического полушарного инсульта / А.А. Козелкин, Л.В. Новикова // Український неврологічний журнал. — 2015. — № 1. — С. 22-28.

Козелкин А.А., Новикова Л.В. Клинико-параклинические и нейропсихологические особенности у больных с повторным мозговым полушарным ишемическим инсультом / А.А. Козелкин, Л.В. Новикова // Український неврологічний журнал. — 2017. — № 2. — С. 31-39.

Міщенко Т.С. Епідеміологія захворювань нервової системи в Україні / Т.С. Міщенко // Український вісник психоневрології. — 2015. — Т. 23, вип. 3(84). — С. 151-152.

Сумин А.Н. и соавт. Годовой прогноз у больных с острым нарушением мозгового кровообращения: роль патологического лодыжечно-плечевого индекса / А.Н. Сумин и соавт. // Рациональная фармакотерапия в кардиологии. — 2016. — № 6. — С. 638-644.

Andersen K.K., Andersen Z.J. Stroke Predictors of early and late case-fatality in a nationwide Danish study of 26,818 patients with first-ever ischemic stroke // Stroke. — 2011. — 42(10). — Р. 2806-2812.

Callahan A., Amarenco P., Goldstein L.B., Sillesen H. et al. SPARCL Investigators. Risk of stroke and cardiovascular events after ischemic stroke or transient ischemic attack in patients with type 2 diabetes or metabolic syndrome: secondary analysis of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial // Arch. Neurol. — 2011. — 68. —

Р. 1245-1251.

Banerjee C., Moon Y.P., Paik M.C., Rundek T., Mora-McLaughlin C., Vieira J.R., Sacco R.L., Elkind M.S. Duration of diabetes and risk of ischemic stroke: the Northern Manhattan Study //

Stroke. — 2012. — 43. — Р. 1212-1217.

Feigin V.L., Forouzanfar M.H., Krishnamurthi R., Mensah G.A., Connor M., Bennett D.A. Global and regional burden of stroke during 1990–2010: findings from the global burden of disease study 2010 // Lancet. — 2014. — 383. — Р. 245-254.

Lima F.O., Furie K.L., Silva G.S. et al. Prognosis of untrea­ted strokes due to anterior circulation proximal intracranial arterial occlusions detected by use of computed tomography angiography // JAMA Neurol. — 2014. — 71. — Р. 151-157.

Mathias T.L., Albright K.C., Boehme A.K. et al.Сardiac function and short-term outcome in patients with acute ischemic stroke: A cross-sectional study // J. Cardiovasc. Dis. — 2013. — 1. — Р. 26-29.

Ovbiagele B., Saver J.L. Day-90 acute ischemic stroke outcomes can be derived from early fun ctional activity level // Cerebrovasc. Dis. — 2010. — 29. — Р. 50-56.

Saposnik G., Black S.E., Hakim A. et al. Аge disparities in stroke quality of care and delivery of health services // Stroke. — 2009. — 40. — Р. 3328-3335.




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