Impact of Functional Status on Noncardioembolic Ischemic Stroke Recurrence Within 1 Year: The Korean Stroke Cohort for Functioning and Rehabilitation Study
- 주제(키워드) comorbidity , disability evaluation , function , recurrence , stroke
- 주제(기타) Clinical Neurology
- 설명문(일반) [Kim, Min-Su; Joo, Min Cheol] Wonkwang Univ, Sch Med, Dept Rehabil Med, 895 Muwang Ro, Iksan 54538, South Korea; [Kim, Min-Su; Joo, Min Cheol] Inst Wonkwang Med Sci, 895 Muwang Ro, Iksan 54538, South Korea; [Sohn, Min Kyun] Chungnam Natl Univ, Sch Med, Dept Rehabil Med, Daejeon, South Korea; [Lee, Jongmin] Konkuk Univ, Sch Med, Dept Rehabil Med, Seoul, South Korea; [Kim, Deog Young] Yonsei Univ, Coll Med, Dept & Res Inst Rehabil Med, Seoul, South Korea; [Lee, Sam-Gyu] Chonnam Natl Univ, Sch Med, Dept Phys & Rehabil Med, Gwangju, South Korea; [Shin, Yong-Il; Kim, Soo-Yeon] Pusan Natl Univ, Yangsan Hosp, Sch Med, Dept Rehabil Med, Yangsan, South Korea; [Oh, Gyung-Jae] Wonkwang Univ, Sch Med, Dept Prevent Med, Iksan, South Korea; [Lee, Yang-Soo] Kyungpook Natl Univ, Sch Med, Kyungpook Natl Univ Hosp, Dept Rehabil Med, Daegu, South Korea; [Han, Eun Young] Jeju Natl Univ, Sch Med, Jeju Natl Univ Hosp, Dept Rehabil Med, Jeju, South Korea; [Han, Junhee] Hallym Univ, Dept Stat, Chunchon, South Korea; [Ahn, Jeonghoon] Ewha Womans Univ, Dept Hlth Convergence, Seoul, South Korea; [Chang, Won Hyuk; Kim, Yun-Hee] Sungkyunkwan Univ, Sch Med, Dept Phys & Rehabil Med, 81 Irwon Ro, Seoul 06351, South Korea
- 등재 SCIE, SCOPUS, KCI등재
- OA유형 Green Submitted, Green Published, gold
- 발행기관 KOREAN NEUROLOGICAL ASSOC
- 발행년도 2019
- URI http://www.dcollection.net/handler/ewha/000000160404
- 본문언어 영어
- Published As http://dx.doi.org/10.3988/jcn.2019.15.1.54
- PubMed https://pubmed.ncbi.nlm.nih.gov/30618217
초록/요약
Background and Purpose Few studies have investigated the relationship between the specific functional factors potentially associated with functional level and stroke recurrence. We conducted a study of patients with noncardioembolic ischemic stroke (NCIS) to determine the functional factors affecting recurrence within the first year. Methods In total, 568 first-ever NCIS patients (age=65.1 +/- 17.4 years, mean +/- SD) were analyzed in a multicenter, prospective cohort study registered from August 2012. Demographic characteristics, past medical history, comorbidities, laboratory data, stroke features in neuroimaging, acute treatments, and medications at discharge were assessed. Functional factors reflecting gross functional impairment, ambulatory function, motor function, activities of daily living, cognition, language ability, swallowing function, mood, and quality of life were comprehensively evaluated in face-to-face assessments using standardized tools at the time of discharge. Results The cumulative incidence of stroke recurrence in NCIS was 6.0% (n=34) at 1 year. The period from admission to discharge was 34.4 +/- 7.0 days. The independent predictors of stroke recurrence within 1 year in multivariate Cox proportional-hazards regression analyses were 1) age [per-year hazard ratio (HR)=1.04, 95% confidence interval (CI)=0.97-1.06, p=0.048], 2) Charlson Comorbidity Index higher than 2 (HR=1.72, 95% CI=1.26-2.22, p= 0.016), 3) modified Rankin Scale score of 3 or more at discharge (HR=1.56, 95% CI=1.22-1.94, p=0.032), and 4) Functional Ambulation Category of 3 or less at discharge (HR=2.56, 95% CI= 1.84-3.31, p=0.008). Conclusions In addition to patient age, moderate-to-severe functional impairment requiring the help of others (especially for ambulation) at the time of discharge and the severity of comorbidity were independent predictors of stroke recurrence within 1 year of the first NCIS.
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