Kaplan Yüksel, Kamişli Özden, Altinayar Sibel, Özcan Cemal
Department of Neurology, İnönü University Faculty of Medicine, Malatya, Turkey.
Noro Psikiyatr Ars. 2015 Jun;52(2):117-123. doi: 10.5152/npa.2015.7653. Epub 2015 Jun 1.
Few studies have reported the predictive factors related to mortality in patients with cranio-cervical artery dissections (CCAD). Our aim was to investigate the predictors related to in-hospital mortality in patients with CCAD and its subgroups.
Sixty-seven patients diagnosed with carotid artery dissection (CAD) or vertebral artery dissection (VAD), admitted to our clinic between 2000 and 2013, were retrospectively reviewed. Age, gender, modified Rankin Scale scores (pre-stroke and at admission), clinical presentation type, location of the dissection, risk factors, and treatments were analyzed as mortality-related prognostic factors. Of the 67 patients, 12 (17.9%) died, five (7.46%) with CAD and seven (10.44%) with VAD. We compared the prognostic characteristics of the surviving versus deceased patients with CCAD and in the subgroups with CAD and VAD.
Age above 45 years, severe disability at admission, presentation with stroke, and intracranial VAD occurred more frequently in deceased patients and were independent variables related to mortality in patients with CCAD and its subgroup with VAD. Severe disability at admission alone was related to mortality in patients with CAD. Hypertension and hypercholesterolemia were independent variables related to mortality in patients with CCAD.
Severe disability at admission was a mortality predictor in both CAD and VAD. Although the initial severity of stroke is reportedly related to poor outcomes in patients with CCAD, it has not previously been directly identified as a predictor of mortality in patients with CAD or VAD.
很少有研究报道颅颈动脉夹层（CCAD）患者的死亡预测因素。我们的目的是研究CCAD患者及其亚组的院内死亡预测因素。
回顾性分析了2000年至2013年间收治于我院的67例诊断为颈动脉夹层（CAD）或椎动脉夹层（VAD）的患者。分析年龄、性别、改良Rankin量表评分（卒中前及入院时）、临床表现类型、夹层位置、危险因素及治疗情况等与死亡相关的预后因素。67例患者中，12例（17.9%）死亡，其中5例（7.46%）为CAD患者，7例（10.44%）为VAD患者。我们比较了CCAD存活患者与死亡患者以及CAD和VAD亚组患者的预后特征。
45岁以上、入院时严重残疾、卒中表现以及颅内VAD在死亡患者中更为常见，是CCAD患者及其VAD亚组患者死亡的独立相关变量。仅入院时严重残疾与CAD患者的死亡相关。高血压和高胆固醇血症是CCAD患者死亡的独立相关变量。
入院时严重残疾是CAD和VAD患者的死亡预测因素。虽然据报道CCAD患者卒中的初始严重程度与不良预后相关，但此前尚未直接确定其为CAD或VAD患者死亡的预测因素。
