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Impact of Functional Status on Noncardioembolic Ischemic Stroke Recurrence Within 1 Year: The Korean Stroke Cohort for Functioning and Rehabilitation Study
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 affecti...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Neurological Association
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6325355/ https://www.ncbi.nlm.nih.gov/pubmed/30618217 http://dx.doi.org/10.3988/jcn.2019.15.1.54 |
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author | Kim, Min-Su Joo, Min Cheol Sohn, Min Kyun Lee, Jongmin Kim, Deog Young Lee, Sam-Gyu Shin, Yong-Il Kim, Soo-Yeon Oh, Gyung-Jae Lee, Yang-Soo Han, Eun Young Han, Junhee Ahn, Jeonghoon Chang, Won Hyuk Kim, Yun-Hee |
author_facet | Kim, Min-Su Joo, Min Cheol Sohn, Min Kyun Lee, Jongmin Kim, Deog Young Lee, Sam-Gyu Shin, Yong-Il Kim, Soo-Yeon Oh, Gyung-Jae Lee, Yang-Soo Han, Eun Young Han, Junhee Ahn, Jeonghoon Chang, Won Hyuk Kim, Yun-Hee |
author_sort | Kim, Min-Su |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6325355 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Korean Neurological Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-63253552019-01-11 Impact of Functional Status on Noncardioembolic Ischemic Stroke Recurrence Within 1 Year: The Korean Stroke Cohort for Functioning and Rehabilitation Study Kim, Min-Su Joo, Min Cheol Sohn, Min Kyun Lee, Jongmin Kim, Deog Young Lee, Sam-Gyu Shin, Yong-Il Kim, Soo-Yeon Oh, Gyung-Jae Lee, Yang-Soo Han, Eun Young Han, Junhee Ahn, Jeonghoon Chang, Won Hyuk Kim, Yun-Hee J Clin Neurol Original Article 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. Korean Neurological Association 2019-01 2018-12-28 /pmc/articles/PMC6325355/ /pubmed/30618217 http://dx.doi.org/10.3988/jcn.2019.15.1.54 Text en Copyright © 2019 Korean Neurological Association http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Kim, Min-Su Joo, Min Cheol Sohn, Min Kyun Lee, Jongmin Kim, Deog Young Lee, Sam-Gyu Shin, Yong-Il Kim, Soo-Yeon Oh, Gyung-Jae Lee, Yang-Soo Han, Eun Young Han, Junhee Ahn, Jeonghoon Chang, Won Hyuk Kim, Yun-Hee Impact of Functional Status on Noncardioembolic Ischemic Stroke Recurrence Within 1 Year: The Korean Stroke Cohort for Functioning and Rehabilitation Study |
title | Impact of Functional Status on Noncardioembolic Ischemic Stroke Recurrence Within 1 Year: The Korean Stroke Cohort for Functioning and Rehabilitation Study |
title_full | Impact of Functional Status on Noncardioembolic Ischemic Stroke Recurrence Within 1 Year: The Korean Stroke Cohort for Functioning and Rehabilitation Study |
title_fullStr | Impact of Functional Status on Noncardioembolic Ischemic Stroke Recurrence Within 1 Year: The Korean Stroke Cohort for Functioning and Rehabilitation Study |
title_full_unstemmed | Impact of Functional Status on Noncardioembolic Ischemic Stroke Recurrence Within 1 Year: The Korean Stroke Cohort for Functioning and Rehabilitation Study |
title_short | Impact of Functional Status on Noncardioembolic Ischemic Stroke Recurrence Within 1 Year: The Korean Stroke Cohort for Functioning and Rehabilitation Study |
title_sort | impact of functional status on noncardioembolic ischemic stroke recurrence within 1 year: the korean stroke cohort for functioning and rehabilitation study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6325355/ https://www.ncbi.nlm.nih.gov/pubmed/30618217 http://dx.doi.org/10.3988/jcn.2019.15.1.54 |
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