Prognosis of patients with unilateral extracranial occlusion of the internal carotid artery.

Waltimo, O.; Kaste, Markku; Fogelholm, R

doi:10.1161/01.str.7.5.480

Cited by 22 publications

(9 citation statements)

References 23 publications

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“…1< " 3 ' 25 Transient ischemic attacks prior to stroke and comorbid hypertension did not influence outcome. In the previous Finnish study, 26 hypertension did not have any correlation with ADL either.…”

Section: Profile Of Recovery and Outcome After Stroke/tfo/iva El A!mentioning

confidence: 58%

The profile of recovery from stroke and factors influencing outcome.

Kotila¹,

Waltimo²,

Niemi³

et al. 1984

Stroke

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134

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The recovery from stroke of 154 survivors out of 255 stroke patients was analyzed. The outcomes documented were: discharge from hospital, activities of daily living (ADL) and return to work. A clear improvement in neurological and neuropsychological deficits was seen from the acute stage to three months, and this continued to twelve months, but to a lesser degree. 69% and 78% respectively, of the patients were at home three and twelve months after stroke. Independence in ADL increased from 32% acutely to 62% and 68% by three and twelve months, respectively. Of those gainfully employed prior to stroke, 55% had returned to work after twelve months. As a group, SAH patients seemed to recover better, but, for those that could be age-matched with infarction patients, there was no difference in outcome. Old age, acute stage hemiparesis, impairment of intelligence and memory, visuoperceptual deficits, nonadequate emotional reactions, and living alone all had a major negative influence on outcome. This study suggests that neurological and neuropsychological deficits, as well as emotional reactions, influence the outcomes after stroke, and all should be taken into consideration in prognosis.

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Section: Profile Of Recovery and Outcome After Stroke/tfo/iva El A!mentioning

confidence: 58%

The profile of recovery from stroke and factors influencing outcome.

Kotila¹,

Waltimo²,

Niemi³

et al. 1984

Stroke

Self Cite

301

134

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“…However, none of the studies, in which the type and localization of stroke were specified, differentiated between diagnostic strata in their prediction model. Some studies confined their target group to, for instance, ischaemic strokes in the region supplied by the anterior cerebral arteries [33,75,96,110,115,125]', left or right hemispheres [69,74,97] or supratentorial haemorrhagic strokes [76,108]. Altogether, only 31 studies provided information about stroke characteristics as well as recurrent strokes in the cohort.…”

Section: Resultsmentioning

confidence: 99%

Predicting Disability in Stroke—A Critical Review of the Literature

Kwakkel

Wagenaar

Kollen³

et al. 1996

Age Ageing

411

294

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SummaryResearch articles on the prognosis of stroke patients were analysed to identify studies that met sound methodological principles of prognostic research as well as to identify variables capable of predicting functional outcome (ADL) after stroke. Data sources comprised a computer-aided search of published prognostic studies and references to literature used in prognostic studies. Seventy-eight studies were tested for adherence to the following key methodological criteria: reliability and validity of measurement instruments used to assess dependent and independent variables; inclusion of an inception cohort; adequate and uniform end-point of observation; control for drop-outs during period of observation; statistical testing of presumed relationship between dependent and independent variables; sufficient sample size in relation to number of determinants; control for multicollinearity; specification of patient characteristics (i.e. age, type, recurrent stroke and localization of stroke); description of interfering treatment effects during the period of observation; and crossvalidation of the prediction model in a second independent group of patients.Only three studies satisfied nine out of 11 criteria and ten studies eight criteria for the determination of valid prognostic research. The results of these studies indicate that the following variables are valid predictors for functional recovery after stroke: age; previous stroke; urinary continence; consciousness at onset; disorientation in time and place; severity of paralysis; sitting balance; admission ADL score; level of social support and metabolic rate of glucose outside the infarct area in hypertensive patients. This study supports the general opinion that not only are differences in objectives and heterogeneity in stroke patients responsible for the lack of accuracy in predicting functional outcome, but also the methodological flaws in published prognostic research.

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“…[3][4][5][6][7][8][9][10][11][12] For example, mortality rates of 7% to 37% 5,7,8,10,13 after ischemic stroke have been reported in the first year after a stroke, with a 5% to 11% 8,10 annual risk of death for each year thereafter and a 5-year mortality of 53% to 60%. 5,7,8 This prior research, however, only included patients with first strokes, 5 younger stroke patients, 6 cohorts from past eras, 7,9 participants enrolled in clinical trials, 13 cohorts from a single city or center, 3,4,7 or cohorts from outside of the United States. 3-5,8 -10 Accurate estimates of both the absolute mortality rates and the pattern of mortality in cerebrovascular disease over time are required by clinicians caring for patients, researchers designing clinical trials, and policy makers allocating limited healthcare resources.…”

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confidence: 99%

Long-Term Mortality in Cerebrovascular Disease

Bravata

Brass

et al. 2003

Stroke

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Background and Purpose-Stroke is the third leading cause of death in the United States, yet data are limited about the temporal pattern of mortality among patients with cerebrovascular disease. The objectives of this study were to identify predictors of 6-month mortality and to evaluate 5-year mortality in patients with cerebrovascular disease. Methods-Our population included fee-for-service Medicare beneficiaries aged Ն65 years who were discharged with an acute ischemic stroke, transient ischemic attack (TIA), or carotid stenosis (International Classification of Diseases, Ninth Revision, Clinical Modification codes 433 to 436) from Connecticut acute care hospitals in 1995. This cohort was followed through 2000 by means of part A Medicare claims and Social Security Administration mortality data. Results-Among 5123 patients, 4781 survived their hospitalization and were followed for an average of 3.4 years; 670 (14.0%) died within 6 months of discharge, and 2517 (52.6%) died within 5 years. Predictors of 6-month mortality included older age, male sex, increasing comorbidity, discharge not to home, and prior admission within a year of the index hospitalization. The annual mortality rates for year 1 after discharge differed depending on the discharge diagnosis of the index hospitalization: carotid stenosis, 10.6%; TIA, 14.8%; and acute ischemic stroke, 26.4%. The 5-year cumulative mortality rates were as follows: carotid stenosis, 38.3%; TIA, 49.6%; and acute ischemic stroke, 60.0%. Conclusions-Mortality

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Prognosis of patients with unilateral extracranial occlusion of the internal carotid artery.

Cited by 22 publications

References 23 publications

The profile of recovery from stroke and factors influencing outcome.

The profile of recovery from stroke and factors influencing outcome.

Predicting Disability in Stroke—A Critical Review of the Literature

Long-Term Mortality in Cerebrovascular Disease

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