School of Psychiatry, Primary Dementia Collaborative Research Centre, University of New South Wales, Sydney, Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, Sydney, New South Wales, Australia.
J Stroke Cerebrovasc Dis. 2010 Nov-Dec;19(6):485-93. doi: 10.1016/j.jstrokecerebrovasdis.2009.09.006. Epub 2010 Jun 9.
We explored th effects of vascular mild cognitive impairment (VaMCI), vascular dementia (VaD), and other predictors on mortality and institutionalization in early survivors of ischemic stroke without previous dementia who had been admitted to a stroke unit. A total of 202 consecutive consenting eligible ischemic stroke survivors and a matched sample of 97 community controls were followed for up to 10 years. Data for 167 patients who underwent detailed assessment 3-6 months after stroke were analyzed to determine predictors of outcomes. Cumulative mortality rates for patients (and controls) were 27% (4%) for the first 5 years and rose to 83% (10%) by 10 years. Predictors of mortality were older age, any cognitive impairment, less independent function, and less education. Nursing home admission rates were 24% at 5 years and 32% at 10 years for patients and 0 for controls over 8.9 years. Predictors of institutionalization were less independent function and older age. Patients with ischemic stroke who survive the first week have moderate, lower-than-expected mortality rates in the first 5 years that increase thereafter. VaMCI, VaD, and functional decline are predictors of mortality, while functional decline and older age predict institutionalization.
我们探讨了血管性轻度认知障碍（VaMCI）、血管性痴呆（VaD）和其他预测因素对缺血性卒中后无先前痴呆且入住卒中单元的早期幸存者的死亡率和住院率的影响。对 202 名连续同意的符合条件的缺血性卒中幸存者和 97 名匹配的社区对照者进行了长达 10 年的随访。对 167 名在卒中后 3-6 个月接受详细评估的患者进行了数据分析，以确定结局的预测因素。患者（和对照者）的累积死亡率在前 5 年为 27%（4%），10 年后上升至 83%（10%）。死亡率的预测因素为年龄较大、任何认知障碍、功能独立性较低和受教育程度较低。卒中后 5 年患者的入院率为 24%，10 年为 32%，而 8.9 年以上的对照者为 0。住院的预测因素为功能独立性较低和年龄较大。存活至第 1 周的缺血性卒中患者在前 5 年内有中度、低于预期的死亡率，此后会增加。VaMCI、VaD 和功能下降是死亡率的预测因素，而功能下降和年龄较大是住院的预测因素。
