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Acta Neurológica Colombiana
versión impresa ISSN 0120-8748versión On-line ISSN 2422-4022
Resumen
JIMENEZ YEPES, Carlos Mario et al. Prognosis role of factors associated with anterior circulation stroke: a cohort study. Acta Neurol Colomb. [online]. 2021, vol.37, n.1, pp.12-19. Epub 08-Mayo-2021. ISSN 0120-8748. https://doi.org/10.22379/24224022356.
INTRODUCTION:
Cerebrovascular disease constitutes a public health problem. This entity represents an important cause of permanent disability in adults, social, economic and health impact as well. The high costs demanded by health care from the moment of diagnosis, initial management of the event, and subsequent rehabilitation-palliation of the sequelae, requires knowledge of population characteristics and possible prognostic factors. This can be useful as an input for planning prevention services for people at risk and care of stroke patients.
OBJECTIVE:
To identify the prognostic role that some factors associated with the ischemic lesion have regarding the degree of disability and mortality, in the cerebral infarction of the anterior circulation.
Methods:
Observational, analytical, prospective cohort study was performed, with a nested case-control analysis. Neurological involvement was measured at admission with the NIHSS scale. At three months post-event, the modified Rankin scale (mRS: dependent variable) was measured, pursuing residual disability and mortality; cases: patient with unfavorable mRS score (score: 3, 4, 5, 6); controls: patient with favorable mRS score (score: 0, 1, 2).
RESULTS:
93 patients with diagnosis of ischemic stroke of anterior circulation were included. Median age was 67 years RIQ (57-76); most frequent NIHSS was moderate (50; 53.8 %) and the median evolution time to medical management was 5 hours RIQ (3-24 hours). Etiology was identified in 33 patients (35.5 %, cardio-embolic the most). After 90 days since ischemic injury, most frequent mRS was "3: moderate" (22; 23.7 %) and 7 (7.5 %) patients died. Bivariate analysis identified left hemisphere stroke as an unfavorable variable in terms of disability at three months compared to the right hemisphere (OR 2.51, 95 % CI 1.06-5.9, p = 0.03).
CONCLUSIONS:
The population with ischemic stroke was predominantly males with multiple comorbidities, with a moderate neurological compromise on admission (NIHSS score: 5-15). After three months post event, patients were predominantly with reduced mobility, some mental functions affection, but essentially independent in activities of daily living. The involvement of left hemisphere is projected as poor prognostic factor in the functional recovery of our patients.
Palabras clave : infarction, anterior cerebral artery; cerebral infarction; disability evaluation; probability; prognosis; stroke; functional laterality (MeSH).