López-González F J, Aldrey J M, Cacabelos P, Castillo J
Servicio de Neurología, Complexo Hospitalario Universitario de Santiago-Hospital Xeral de Galicia, Santiago de Compostela, España.
Rev Neurol. 1998 Sep;27(157):473-7.
Acute cerebrovascular disease is a serious neurological problem. Mortality is between 6% and 30%. Most studies are in agreement that advanced age, type of ictus, size of lesion and clinical deterioration are factors determining mortality. However, its relationship to vascular risk factors is not completely clear.
To analyze the repercussion of different vascular risk factors on mortality during the acute phase of ictus.
We studied all patients with ictus admitted to the Servicio de Neurología of the Hospital Xeral de Galicia de Santiago de Compostela over a period of 3 years (n = 915). We recorded vascular risk factors and analyzed the causes of mortality whilst in hospital.
Hospital mortality due to ictus was 16.8%. Mortality was 14.5% in cerebral infarct, 23.2% in intracerebral haemorrhage and 19.4% in subarachnoid haemorrhage. A total of 20.8% of the patients died of neurological causes, 24.7% of vascular causes, 26% due to infection and of uncertain causes in the remaining 28.6%. There was a neurological cause of death in 46.1% of the patients with subarachnoid haemorrhage, 25.5% with intracerebral haemorrhage and 14.8% with cerebral infarcts. Vascular risk factors associated with greater mortality were age (p < 0.001) and a history of cardiopathy (p < 0.05).
Vascular risk factors which indicated worse prognosis were: age, type of ictus and a history of cardiopathy.
急性脑血管疾病是一个严重的神经学问题。死亡率在6%至30%之间。大多数研究一致认为，高龄、发作类型、病变大小和临床恶化是决定死亡率的因素。然而，其与血管危险因素的关系尚不完全清楚。
分析不同血管危险因素对发作急性期死亡率的影响。
我们研究了圣地亚哥德孔波斯特拉的加利西亚泽拉尔医院神经科在3年期间收治的所有发作患者（n = 915）。我们记录了血管危险因素，并分析了住院期间的死亡原因。
因发作导致的医院死亡率为16.8%。脑梗死死亡率为14.5%，脑出血为23.2%，蛛网膜下腔出血为19.4%。共有20.8%的患者死于神经原因，24.7%死于血管原因，26%死于感染，其余28.6%死因不明。蛛网膜下腔出血患者中46.1%有神经源性死亡原因，脑出血患者中25.5%有神经源性死亡原因，脑梗死患者中14.8%有神经源性死亡原因。与较高死亡率相关的血管危险因素是年龄（p < 0.001）和心脏病史（p < 0.05）。
提示预后较差的血管危险因素为：年龄、发作类型和心脏病史。
