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首页> 外文期刊>Journal of neurology >Long-term mortality and risk of stroke after transient ischemic attack: a hospital-based cohort study.
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Long-term mortality and risk of stroke after transient ischemic attack: a hospital-based cohort study.

机译：短暂性脑缺血发作后的长期死亡率和中风风险：一项基于医院的队列研究。

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BACKGROUND: Stroke and mortality rates in patients with transient ischemic attack (TIA) differ widely between community-based studies and research cohorts. Our aim therefore was to provide a reliable estimate for TIA patients treated in German neurology departments with an acute stroke unit. METHODS: A total of 1951 consecutively admitted TIA patients were prospectively documented in 13 centers and 1480 (75.9%) gave consent for long-term follow-up. During a mean follow-up of 23.4 months, we assessed recurrent cerebrovascular events and cause of death in 1448 patients via standardized telephone interview including confirmation of endpoint events by the treating physician. RESULTS: Overall 94 patients (6.5%) suffered a stroke and 118 patients (8.1%) died, 21 due to stroke. The Kaplan-Meier estimate for stroke during the first year was 4.4% (95% CI 3.2-5.6%) which corresponds to a relative risk of 9.5 (95% CI 7.4-12.3) compared to the population-based stroke incidence in Germany. The annual rates after the first year were 2.2% (95% CI 1.7-2.7%) for stroke and 3.2% (95% CI 2.7-3.8%) for death. Independent predictors for stroke during follow-up were age and previous cerebrovascular events. The ABCD(2) score did not provide any meaningful prediction of stroke risk at 90 days. CONCLUSION: While the in-hospital risk of stroke was low, long-term stroke rates in our well-defined multicenter hospital-based cohort were comparable to a large randomized trial. In patients with a well-established diagnosis of TIA, only age and previous cerebrovascular events seem to constitute independent predictors for stroke during long-term follow-up.
机译：背景：基于社区的研究与研究人群之间，短暂性脑缺血发作（TIA）患者的中风和死亡率差异很大。因此，我们的目的是为在德国神经病学部门接受过急性卒中治疗的TIA患者提供可靠的估计。方法：前瞻性地记录了13个中心的1951名连续入院的TIA患者，有1480名（75.9％）同意接受长期随访。在平均23.4个月的随访期间，我们通过标准化电话采访（包括治疗医师确认终点事件）评估了1448例患者的复发性脑血管事件和死亡原因。结果：总共有94名患者（6.5％）患有中风，有118名患者（8.1％）死亡，其中21人是中风。在第一年中，Kaplan-Meier对中风的估计为4.4％（95％CI 3.2-5.6％），与德国基于人群的中风发生率相比，相对风险为9.5（95％CI 7.4-12.3）。第一年后的中风年死亡率为2.2％（95％CI 1.7-2.7％），而死亡为3.2％（95％CI 2.7-3.8％）。随访期间中风的独立预测因素是年龄和先前的脑血管事件。 ABCD（2）评分未提供90天卒中风险的任何有意义的预测。结论：尽管院内卒中风险较低，但在我们明确定义的多中心医院队列研究中，长期卒中发生率与大型随机试验相当。在确诊为TIA的患者中，在长期随访期间，只有年龄和先前的脑血管事件似乎是卒中的独立预测因子。

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