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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >The Risk Factors for Death within 6 Months After Ischemic Stroke in Patients with Cancer
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The Risk Factors for Death within 6 Months After Ischemic Stroke in Patients with Cancer

机译：患有癌症患者缺血性脑卒中后6个月内死亡的危险因素

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Objectives: While the intravenous recombinant tissue plasminogen activator (rt-PA) therapy for acute ischemic stroke patients with cancer is recommended when survival of >= 6 months is expected, the risk factors for death and stroke recurrence within 6 months after stroke are not well known. Thus, we aimed to identify markers for death and recurrence risks within six months from stroke onset in patients with cancer. Materials and Methods: In a retrospective cohort study, the subjects comprised acute ischemic stroke patients with cancer hospitalized at St. Marianna University hospital from 2008 through 2019. To evaluate the associations between the clinical factors within 24 h of the initial stroke and death or stroke recurrence events within 6 months from stroke onset, Logistic analysis and Cox proportional hazards regression analysis was used respectively. Next, the optimal cutoff point of markers for different mortality groups was determined using the receiver operating characteristic curve analysis and cumulative outcome rate of each group was compared using the Kaplan-Meier method. Results: Among 194 patients with cancer who developed acute stroke, 167 were ultimately selected for analysis. 47 subjects (28.14%) passed away within 6 months following stroke onset, and 20 subjects (11.98%) had stroke recurrence. High D-dimer levels, low fibrinogen levels, high Glasgow prognostic scores (GPS), and multiple vascular territory infarctions was independently associated with death, where higher death rate was significantly confirmed in the group with D-dimer levels of >= 3.95 mg/dl, fibrinogen levels <277.5 mg /dl and GPS scores of 2. Low fibrinogen level, lack of antithrombotic therapy, and the presence of metastasis were associated with stroke recurrence. Conclusions: When patients with cancer suffer stroke, D-dimer levels, fibrinogen levels, GPS, and multiple vascular territory infarctions would be associated with the risk of death within 6 months. Low fibrinogen levels, lack of antithrombotic therapy, and the presence of metastasis correlated with high risk of stroke recurrence.
机译：目的：当预期生存期大于等于6个月时，建议对患有癌症的急性缺血性卒中患者进行静脉注射重组组织纤溶酶原激活剂（rt PA）治疗，但卒中后6个月内死亡和卒中复发的风险因素尚不清楚。因此，我们的目标是在癌症患者中风发病后六个月内确定死亡和复发风险的标志物。材料和方法：在一项回顾性队列研究中，受试者包括2008年至2019年在圣玛丽安娜大学医院住院的急性缺血性中风癌症患者。为了评估首次卒中后24小时内的临床因素与卒中发病后6个月内的死亡或卒中复发事件之间的相关性，分别采用了Logistic分析和Cox比例风险回归分析。接下来，使用受试者操作特征曲线分析确定不同死亡率组的最佳标志物截止点，并使用Kaplan-Meier方法比较各组的累积结局率。结果：在194例发生急性卒中的癌症患者中，最终选择167例进行分析。47名受试者（28.14%）在中风发作后6个月内死亡，20名受试者（11.98%）中风复发。高D-二聚体水平、低纤维蛋白原水平、高格拉斯哥预后评分（GPS）和多发性血管区域梗死与死亡独立相关，在D-二聚体水平>=3.95 mg/dl、纤维蛋白原水平<277.5 mg/dl和GPS评分为2的组中，死亡率显著升高。低纤维蛋白原水平、缺乏抗血栓治疗和存在转移与卒中复发相关。结论：当癌症患者发生卒中时，D-二聚体水平、纤维蛋白原水平、GPS和多发性血管区域梗死与6个月内死亡风险相关。低纤维蛋白原水平、缺乏抗血栓治疗和存在转移与卒中复发的高风险相关。

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