Tuttolomondo Antonino, Pedone Claudio, Pinto Antonio, Di Raimondo Domenico, Fernandez Paola, Di Sciacca Riccardo, Licata Giuseppe
Biomedical Department of Internal and Specialistic Medicine, University of Palermo, Italy.
Int J Cardiol. 2008 Apr 25;125(3):391-6. doi: 10.1016/j.ijcard.2007.03.109. Epub 2007 May 8.
Today it may be more useful to use the term acute ischemic cerebrovascular syndrome (AICS) to define a spectrum of disease ranging from TIA to stroke and that share a similar underlying pathophysiology: cerebral ischemia. The aim of this study is to evaluate the prognostic importance of some demographic, laboratory and clinical variables on the outcome in hospitalized patients with a discharge diagnosis suggestive of acute ischemic cerebral syndrome (AICS).
17,377 Subjects were enrolled in the GIFA study, a multicenter survey of hospitalized older patients. 1878 Subjects with a main discharge diagnosis suggestive of acute ischemic cerebrovascular syndrome (AICS) represent the final sample. The primary outcomes of this study were: (1) in-hospital mortality; (2) cognitive impairment at discharge; (3) functional status at discharge.
Age, WBC count, glucose blood level at admission and Charlson index score were directly associated with in-hospital mortality. Age, WBC count, Charlson index score and disability at admission are directly associated with cognitive impairment at discharge. Finally, age, Charlson index score and disability at admission are directly associated with disability at discharge.
Our study evaluated prognosis in the light of the three main aspects of mortality, disability and cognitive impairment that showed substantial sharing for most of the prognostic factors, probably owing to the possible strict association of these outcome indicators with markers of ischemic brain damage extent (WBC) and/or individual response to an ischemic event by neuroplasticity (age, comorbidity) in subjects with AICS.
如今，使用急性缺血性脑血管综合征（AICS）这一术语来定义从短暂性脑缺血发作（TIA）到中风的一系列疾病可能更有用，这些疾病具有相似的潜在病理生理学：脑缺血。本研究的目的是评估一些人口统计学、实验室和临床变量对出院诊断提示急性缺血性脑综合征（AICS）的住院患者预后的重要性。
17377名受试者参与了GIFA研究，这是一项对住院老年患者的多中心调查。1878名主要出院诊断提示急性缺血性脑血管综合征（AICS）的受试者代表最终样本。本研究的主要结局为：（1）住院死亡率；（2）出院时的认知障碍；（3）出院时的功能状态。
年龄、白细胞计数、入院时血糖水平和查尔森指数评分与住院死亡率直接相关。年龄、白细胞计数、查尔森指数评分和入院时的残疾状况与出院时的认知障碍直接相关。最后，年龄、查尔森指数评分和入院时的残疾状况与出院时的残疾直接相关。
我们的研究从死亡率、残疾和认知障碍这三个主要方面评估了预后，结果显示大多数预后因素存在大量重叠，这可能是由于这些结局指标与AICS患者缺血性脑损伤程度标志物（白细胞）和/或通过神经可塑性对缺血事件的个体反应（年龄、合并症）之间可能存在密切关联。
