標題: First-ever ischemic stroke in elderly patients: predictors of functional outcome following carotid artery stenting
作者: Lin, Chih-Ming
Chang, Yu-Jun
Liu, Chi-Kuang
Yu, Cheng-Sheng
Lu, Henry Horng-Shing
生物科技學系
統計學研究所
大數據研究中心
Department of Biological Science and Technology
Institute of Statistics
Big Data Res Ctr
關鍵字: modified Rankin scale;resistance index;Barthel index;common carotid artery;cerebral blood volume ratio
公開日期: 1-Jan-2016
摘要: Age is an important risk factor for stroke, and carotid artery stenosis is the primary cause of first-ever ischemic stroke. Timely intervention with stenting procedures can effectively prevent secondary stroke; however, the impact of stenting on various periprocedural physical functionalities has never been thoroughly investigated. The primary aim of this study was to investigate whether prestenting characteristics were associated with long-term functional outcomes in patients presenting with first-ever ischemic stroke. The secondary aim was to investigate whether patient age was an important factor in outcomes following stenting, measured by the modified Rankin scale (mRS). In total, 144 consecutive patients with first-ever ischemic stroke who underwent carotid artery stenting from January 2010 to November 2014 were included. Clinical data were obtained by review of medical records. The Barthel index (BI) and mRS were used to assess disability before stenting and at 12-month follow-up. In total, 72/144 patients showed improvement (mRS[+]), 71 showed stationary and one showed deterioration in condition (mRS[-]). The prestenting parameters, ratio of cerebral blood volume (1.41 vs 1.2 for mRS[-] vs mRS[+]), BI ( 75 vs 85), and high-sensitivity C-reactive protein (hsCRP 5.0 vs 3.99), differed significantly between the two outcome groups (P<0.05). The internal carotid artery/common carotid artery ratio (P=0.011), BI (P=0.019), ipsilateral internal carotid artery resistance index (P=0.003), and HbA1c (P=0.039) were all factors significantly associated with patient age group. There was no significant association between age and poststenting outcome measured by mRS with 57% of patients in the >= 75 years age group showing mRS(-) and 43% showing mRS(+) (P=0.371). Our findings indicate that in our elderly patient series, carotid artery stenting may benefit a significant proportion of carotid stenotic patients regardless of age. Ratio of cerebral blood volume, BI, and admission hsCRP could serve as important predictors of mRS improvement and may facilitate differentiation of patients at baseline.
URI: http://dx.doi.org/10.2147/CIA.S111637
http://hdl.handle.net/11536/134042
ISSN: 1178-1998
DOI: 10.2147/CIA.S111637
期刊: CLINICAL INTERVENTIONS IN AGING
Volume: 11
起始頁: 985
結束頁: 995
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