Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Ann Afr Med. 2024 Jul 1;23(3):328-334. doi: 10.4103/aam.aam_196_23. Epub 2024 Jul 20.
The constantly increasing incidence of stroke in Saudi Arabia substantiates an urgent need to elucidate underlying risk factors and etiologies. In terms of improving outcomes, the predictors of functional outcomes need to be identified as well. As posterior circulation strokes (PCS) have not been studied in detail, the current study aimed to identify the risk factors, etiology, and predictors of outcome in PCS.
This retrospective study included the data for 138 patients with PCS. Demographics, risk factors, clinical signs/symptoms, etiology, and outcome at discharge and 3-month follow-up were recorded. Factors associated with outcomes were identified, and the difference was ascertained using Chi-square, odds ratios, and 95% confidence intervals.
The mean participant age was 58 ± 14.8 years with 73% being males. The mean arrival time was 26.5 ± 31.6 h; with a mean National Institute of Health Stroke scale (NIHSS) score of 7.2 ± 5.6. Motor deficit and dysarthria were the most common presentations. Twenty percent of patients received intravenous recombinant tissue plasminogen activator, whereas endovascular thrombectomy was performed in 9 (6.5%). Follow-up outcome at 3 months was available in 113 (81.8%). Male sex, baseline modified Rankin scale of <2, low baseline NIHSS, and stable or improvement in baseline NIHSS during 24 h of admission were documented as predictors of a good outcome, whereas history of atrial fibrillation and prior stroke, high NIHSS at admission and worsening of symptoms during 24 h of admission, as well as bilateral body involvement were associated with poor outcome.
The functional outcomes and the predictors of functional outcomes did not differ from the previously published literature; however, significant differences were observed in the risk factors and etiological profile in our population. These differences are of potential interest to the researchers and clinicians, as they carry important therapeutic and prognostic implications and need to be verified through large prospective studies.
沙特阿拉伯中风发病率不断上升，这充分说明迫切需要阐明潜在的风险因素和病因。就改善预后而言，也需要确定功能结局的预测因素。由于后循环卒中（PCS）尚未得到详细研究，因此本研究旨在确定 PCS 的风险因素、病因和结局预测因素。
本回顾性研究纳入了 138 例 PCS 患者的数据。记录了人口统计学、危险因素、临床症状/体征、病因以及出院时和 3 个月随访时的结局。确定了与结局相关的因素，并使用卡方检验、优势比和 95%置信区间来确定差异。
平均参与者年龄为 58 ± 14.8 岁，其中 73%为男性。平均到达时间为 26.5 ± 31.6 小时，平均 NIHSS 评分为 7.2 ± 5.6。运动障碍和构音障碍是最常见的表现。20%的患者接受了静脉注射重组组织型纤溶酶原激活剂，9 例（6.5%）进行了血管内血栓切除术。113 例（81.8%）患者在 3 个月时进行了随访。记录到的结局预测因素包括：男性、基线改良 Rankin 量表评分<2、基线 NIHSS 评分低、入院 24 小时内 NIHSS 稳定或改善，而房颤和既往卒中史、入院时 NIHSS 评分高以及入院 24 小时内症状恶化、双侧肢体受累则与不良结局相关。
本研究中功能结局及其功能结局的预测因素与之前发表的文献没有差异；然而，我们人群中的风险因素和病因谱存在显著差异。这些差异对研究人员和临床医生具有潜在的兴趣，因为它们具有重要的治疗和预后意义，需要通过大型前瞻性研究来验证。
