Stroke etiology is associated with outcome in posterior circulation stroke

Chih-Ping Chung, Chin-Sern Yong, Feng-Chi Chang, Wen-Yung Sheng, Hui-Chi Huang, Jui-Yao Tsai, Hung-Yi Hsu, Han-Hwa Hu

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Stroke research and clinical trials have focused mainly on anterior circulation stroke (ACS). Since clinical characteristics, mechanisms, and outcomes of posterior circulation stroke (PCS) have been reported different from ACS, more PCS studies are required, particularly researching the etiologies, to help establish an optimal management strategy.

METHODS: The present study analyzed patients of PCS who were consecutively admitted and registered in Taipei Veterans General Hospital Stroke Registry between 1 January 2012 to 28 February 2014. We demonstrated the distribution of etiologies, compared the clinical characteristics/outcomes among different etiology groups, and used univariate/multivariate analyses to identify the predictors for poor functional outcome (modified Rankin Scale ≥5) at discharge and 3 month.

RESULTS: About 286 patients of PCS were included for analyses. Basilar artery atheromatous branch occlusive disease (BABO, 28.0%) and large artery dissection (25.9%) were the two most common etiologies, followed by large artery atherosclerotic stenosis/occlusion (LAA, 20.6%), cardioembolism (CE, 18.5%) and small vessel disease (7.0%). Age, vascular risk factors, infarct locations and patterns, and outcomes were different among these five etiology groups. Multivariate analyses showed that age >70 y/o (discharge/3 month, OR, 95% CI: 3.05, 1.23-7.56/8.39, 2.32-30.33), admission NIH Stroke Scale >9 (19.50, 8.69-43.75/13.45, 5.59-32.39), and etiology (LAA versus BABO: 5.00, 1.58-15.83/4.00, 1.19-13.4; CE versus BABO: 3.36, 1.02-11.09/4.66, 1.40-15.46) were independently associated with poor functional outcome.

INTERPRETATION: The etiologies of PCS are heterogeneous and shown to be associated with functional outcomes. Our results have shed lights on future pathophysiological research and designs of clinical trials for PCS.

Original languageEnglish
Pages (from-to)510-7
Number of pages8
JournalAnnals of Clinical and Translational Neurology
Volume2
Issue number5
DOIs
Publication statusPublished - May 2015
Externally publishedYes

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Stroke
Multivariate Analysis
Arteries
Clinical Trials
Veterans Hospitals
Basilar Artery
General Hospitals
Registries
Dissection
Pathologic Constriction
Research Design
Light
Research

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Stroke etiology is associated with outcome in posterior circulation stroke. / Chung, Chih-Ping; Yong, Chin-Sern; Chang, Feng-Chi; Sheng, Wen-Yung; Huang, Hui-Chi; Tsai, Jui-Yao; Hsu, Hung-Yi; Hu, Han-Hwa.

In: Annals of Clinical and Translational Neurology, Vol. 2, No. 5, 05.2015, p. 510-7.

Research output: Contribution to journalArticle

Chung, C-P, Yong, C-S, Chang, F-C, Sheng, W-Y, Huang, H-C, Tsai, J-Y, Hsu, H-Y & Hu, H-H 2015, 'Stroke etiology is associated with outcome in posterior circulation stroke', Annals of Clinical and Translational Neurology, vol. 2, no. 5, pp. 510-7. https://doi.org/10.1002/acn3.188
Chung, Chih-Ping ; Yong, Chin-Sern ; Chang, Feng-Chi ; Sheng, Wen-Yung ; Huang, Hui-Chi ; Tsai, Jui-Yao ; Hsu, Hung-Yi ; Hu, Han-Hwa. / Stroke etiology is associated with outcome in posterior circulation stroke. In: Annals of Clinical and Translational Neurology. 2015 ; Vol. 2, No. 5. pp. 510-7.
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T1 - Stroke etiology is associated with outcome in posterior circulation stroke

AU - Chung, Chih-Ping

AU - Yong, Chin-Sern

AU - Chang, Feng-Chi

AU - Sheng, Wen-Yung

AU - Huang, Hui-Chi

AU - Tsai, Jui-Yao

AU - Hsu, Hung-Yi

AU - Hu, Han-Hwa

PY - 2015/5

Y1 - 2015/5

N2 - OBJECTIVE: Stroke research and clinical trials have focused mainly on anterior circulation stroke (ACS). Since clinical characteristics, mechanisms, and outcomes of posterior circulation stroke (PCS) have been reported different from ACS, more PCS studies are required, particularly researching the etiologies, to help establish an optimal management strategy.METHODS: The present study analyzed patients of PCS who were consecutively admitted and registered in Taipei Veterans General Hospital Stroke Registry between 1 January 2012 to 28 February 2014. We demonstrated the distribution of etiologies, compared the clinical characteristics/outcomes among different etiology groups, and used univariate/multivariate analyses to identify the predictors for poor functional outcome (modified Rankin Scale ≥5) at discharge and 3 month.RESULTS: About 286 patients of PCS were included for analyses. Basilar artery atheromatous branch occlusive disease (BABO, 28.0%) and large artery dissection (25.9%) were the two most common etiologies, followed by large artery atherosclerotic stenosis/occlusion (LAA, 20.6%), cardioembolism (CE, 18.5%) and small vessel disease (7.0%). Age, vascular risk factors, infarct locations and patterns, and outcomes were different among these five etiology groups. Multivariate analyses showed that age >70 y/o (discharge/3 month, OR, 95% CI: 3.05, 1.23-7.56/8.39, 2.32-30.33), admission NIH Stroke Scale >9 (19.50, 8.69-43.75/13.45, 5.59-32.39), and etiology (LAA versus BABO: 5.00, 1.58-15.83/4.00, 1.19-13.4; CE versus BABO: 3.36, 1.02-11.09/4.66, 1.40-15.46) were independently associated with poor functional outcome.INTERPRETATION: The etiologies of PCS are heterogeneous and shown to be associated with functional outcomes. Our results have shed lights on future pathophysiological research and designs of clinical trials for PCS.

AB - OBJECTIVE: Stroke research and clinical trials have focused mainly on anterior circulation stroke (ACS). Since clinical characteristics, mechanisms, and outcomes of posterior circulation stroke (PCS) have been reported different from ACS, more PCS studies are required, particularly researching the etiologies, to help establish an optimal management strategy.METHODS: The present study analyzed patients of PCS who were consecutively admitted and registered in Taipei Veterans General Hospital Stroke Registry between 1 January 2012 to 28 February 2014. We demonstrated the distribution of etiologies, compared the clinical characteristics/outcomes among different etiology groups, and used univariate/multivariate analyses to identify the predictors for poor functional outcome (modified Rankin Scale ≥5) at discharge and 3 month.RESULTS: About 286 patients of PCS were included for analyses. Basilar artery atheromatous branch occlusive disease (BABO, 28.0%) and large artery dissection (25.9%) were the two most common etiologies, followed by large artery atherosclerotic stenosis/occlusion (LAA, 20.6%), cardioembolism (CE, 18.5%) and small vessel disease (7.0%). Age, vascular risk factors, infarct locations and patterns, and outcomes were different among these five etiology groups. Multivariate analyses showed that age >70 y/o (discharge/3 month, OR, 95% CI: 3.05, 1.23-7.56/8.39, 2.32-30.33), admission NIH Stroke Scale >9 (19.50, 8.69-43.75/13.45, 5.59-32.39), and etiology (LAA versus BABO: 5.00, 1.58-15.83/4.00, 1.19-13.4; CE versus BABO: 3.36, 1.02-11.09/4.66, 1.40-15.46) were independently associated with poor functional outcome.INTERPRETATION: The etiologies of PCS are heterogeneous and shown to be associated with functional outcomes. Our results have shed lights on future pathophysiological research and designs of clinical trials for PCS.

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DO - 10.1002/acn3.188

M3 - Article

VL - 2

SP - 510

EP - 517

JO - Annals of Clinical and Translational Neurology

JF - Annals of Clinical and Translational Neurology

SN - 2328-9503

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ER -