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波兰卒中患者队列中的不明来源栓塞性卒中。

Embolic strokes of undetermined source in a cohort of Polish stroke patients.

机构信息

2nd Department of Neurology, Institute of Psychiatry and Neurology, ul. Sobieskiego 9, 02-957, Warsaw, Poland.

Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland.

出版信息

Neurol Sci. 2018 Jun;39(6):1041-1047. doi: 10.1007/s10072-018-3322-5. Epub 2018 Mar 19.

Abstract

We aimed to provide a descriptive analysis of embolic stroke of undetermined etiology (ESUS) population based on a long-term prospective stroke registry. We retrospectively analyzed data collected in a detailed registry regarding consecutive patients admitted for first-ever ischemic stroke (IS) between January 2001 and December 2015. We used Org 10172 in Acute Stroke Treatment classification supplemented with ESUS criteria proposed by the Cryptogenic Stroke/ESUS International Working Group. Within the ESUS group, we additionally compared patients ≤ 60 and > 60 years of age. During the study period, there was a total of 3008 (1615 females and 1393 males) admissions of first-ever strokes. The most frequent cause was undetermined (38.7%), followed by cardioembolic (27.7%), large artery atherosclerosis (18.2%), small vessel disease (11.9%), and other determined (3.6%). We identified 326 patients as ESUS, which accounted for 10.8% of all strokes and 28% of strokes of undetermined etiology. ESUS patients were the youngest. Compared to all types of stroke but for those with small vessel disease, ESUS patients were most often independent before stroke and had the least severe neurological deficit at admission and the best outcome at discharge. ESUS patients ≤ 60 years were more frequently independent at discharge than ESUS patients > 60 years. Approximately 11% of patients from our registry met ESUS criteria. ESUS patients were younger when compared to all other stroke etiologies, suffered less severe strokes, and had more favorable outcome at discharge than other groups except for those with small vessel disease strokes.

摘要

我们旨在根据一项长期前瞻性卒中登记研究,对不明原因栓塞性卒中(ESUS)人群进行描述性分析。我们回顾性分析了 2001 年 1 月至 2015 年 12 月期间详细登记的连续首次缺血性卒中(IS)住院患者的数据。我们使用 Org 10172急性卒中治疗分类,并补充了隐源性卒中/ESUS 国际工作组提出的 ESUS 标准。在 ESUS 组中,我们还比较了≤60 岁和>60 岁的患者。在研究期间,共有 3008 例(女性 1615 例,男性 1393 例)首次发生卒中。最常见的病因是不明原因(38.7%),其次是心源性栓塞(27.7%)、大动脉粥样硬化(18.2%)、小血管疾病(11.9%)和其他确定病因(3.6%)。我们共确定了 326 例 ESUS 患者,占所有卒中的 10.8%和不明原因卒中的 28%。ESUS 患者的年龄最小。与所有类型的卒中相比,除小血管疾病患者外,ESUS 患者卒中前独立性最高,入院时神经功能缺损程度最轻,出院时结局最好。年龄≤60 岁的 ESUS 患者出院时独立性高于年龄>60 岁的 ESUS 患者。我们的登记处约有 11%的患者符合 ESUS 标准。与其他卒中病因相比,ESUS 患者更年轻,卒中严重程度较轻,出院时结局较好,除小血管疾病患者外。

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