The Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu, PR China.
Cerebrovasc Dis. 2010;29(4):376-81. doi: 10.1159/000281836. Epub 2010 Feb 9.
Controversy exists as to whether posterior circulation infarction (PCI) has a poorer outcome compared to anterior circulation infarction (ACI). We aimed to investigate whether PCI had different clinical outcomes from ACI in Chinese patients with ischemic stroke.
Data on ischemic stroke patients with ACI or PCI were collected including demographics, risk factors and 1-month, 3-month, and 1-year case fatality and disability (defined as modified Rankin Scale 3-5). Multivariate regression models were used to analyze predictors for death and disability.
Of the 1,962 enrolled cases, 433 (22.1%) had PCI. The case fatality of PCI at 1-month, 3-month and 1-year follow-up (FU) were lower than that of ACI (3.93, 5.3 and 9.7% vs. 7.26, 9.3 and 13.7%, p <0.05), and the proportion of disability was also lower in PCI at 3-month FU (19.6 vs. 29.1%, p<0.001) and 1-year FU (6.5 vs. 15.2%, p<0.001). The adjusted hazard ratio of death for PCI was 0.52 at 1 month (95% CI 0.29-0.94) and 0.52 at 3 months (95% CI 0.31-0.85), and the adjusted odds of disability in patients with PCI was 0.53 at 1 year (95% CI 0.35-0.81).
In our cohort, patients with PCI have a lower risk of death at 1- and 3-month FU and a lower proportion of disability at 1-year FU, which needs to be verified by future studies.
关于后循环梗死（PCI）的结局是否比前循环梗死（ACI）更差，目前仍存在争议。我们旨在研究中国缺血性脑卒中患者中 PCI 是否与 ACI 的临床结局不同。
收集 ACI 或 PCI 缺血性脑卒中患者的数据，包括人口统计学、危险因素以及 1 个月、3 个月和 1 年的病死率和残疾率（定义为改良 Rankin 量表 3-5 分）。采用多变量回归模型分析死亡和残疾的预测因素。
在纳入的 1962 例患者中，433 例（22.1%）为 PCI。PCI 在 1 个月、3 个月和 1 年随访（FU）时的病死率低于 ACI（3.93%、5.3%和 9.7% vs. 7.26%、9.3%和 13.7%，p<0.05），3 个月 FU（19.6% vs. 29.1%，p<0.001）和 1 年 FU（6.5% vs. 15.2%，p<0.001）时残疾的比例也较低。PCI 患者在 1 个月（95%CI 0.29-0.94）和 3 个月（95%CI 0.31-0.85）时死亡的调整后危险比为 0.52，PCI 患者在 1 年时残疾的调整后优势比为 0.53（95%CI 0.35-0.81）。
在本队列中，PCI 患者在 1 个月和 3 个月 FU 时死亡风险较低，1 年 FU 时残疾比例较低，但需要进一步研究证实。
