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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Lateralization of Insular Ischemic Stroke is Not Associated With Any Stroke Clinical Outcomes: The Athens Stroke Registry
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Lateralization of Insular Ischemic Stroke is Not Associated With Any Stroke Clinical Outcomes: The Athens Stroke Registry

机译：绝症缺血性卒中的外侧化与任何中风临床结果无关：雅典中风登记处

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Background: Controversial evidence suggests that right insular stroke may be associated with worse outcomes compared to the left insular ischemic lesion. Objectives: We investigated whether lateralization of insular stroke is associated with early and late outcome in terms of in-hospital complications, stroke recurrence, cardiovascular events, and death. Methods: Data were prospectively collected from the Athens Stroke Registry. Insular cortex involvement was identified based on brain CT scans or MRI images. Patients were followed up prospectively at 1, 3, 6 months after hospital discharge and yearly thereafter up to 5-years or until death. The assessed outcomes were in-hospital complications, functional outcome assessed by the modified Rankin Scale, stroke recurrence, cardiovascular events, and death. Cox-regression analysis was performed to estimate the cumulative probability of each outcome according to the lateralization of insular strokes. Results: Among the 1212 patients, 650 had left insular stroke involvement and 562 had right. New onset of in-hospital atrial fibrillation was similar between right and left insular strokes (11.6% versus 12.9%, P = .484). During the 5-year follow-up sudden death occurred in 21 (3.7%) patients with right insular compared to 30 (4.6%) with left insular stroke (P = .476). There was no difference between left and right insular strokes regarding mortality (adjusted odds ratio [OR]: .92, 95% confidence interval [CI]: .80-1.06), stroke recurrence (4.3% versus 4.9%; adjusted OR: .81 95% CI: .58-1.13), cardiovascular events, and sudden death (adjusted OR: .99, 95% CI: .76-1.29) and on death and dependency (adjusted OR: .88, 95% CI: .75-1.02) during a 5-year follow up. Conclusions: Lateralization of insular ischemic stroke involvement is not associated with stroke outcomes.
机译：背景：有争议的证据表明，与左侧岛叶缺血性病变相比，右侧岛叶卒中可能与更糟糕的预后相关。目的：我们调查了岛叶卒中的偏侧化是否与住院并发症、卒中复发、心血管事件和死亡的早期和晚期结局相关。方法：从雅典中风登记处前瞻性收集数据。根据脑部CT扫描或MRI图像确定岛叶皮质受累。患者在出院后1个月、3个月、6个月进行前瞻性随访，此后每年随访5年或直至死亡。评估结果包括院内并发症、改良Rankin量表评估的功能结果、中风复发、心血管事件和死亡。采用Cox回归分析，根据岛叶卒中的偏侧情况估计每种结果的累积概率。结果：1212例患者中，650例左岛叶卒中受累，562例右岛叶卒中受累。右、左岛叶卒中患者新发的院内心房颤动相似（11.6%对12.9%，P=0.484）。在5年的随访中，21例（3.7%）右侧岛叶卒中患者发生猝死，而30例（4.6%）左侧岛叶卒中患者发生猝死（P=0.476）。在5年的随访中，左右岛叶卒中在死亡率（调整后的优势比[OR]：.92，95%置信区间[CI]：.80-1.06）、卒中复发（4.3%对4.9%；调整后的OR:.81-95%CI:.58-1.13）、心血管事件、猝死（调整后的OR:.99，95%CI:.76-1.29）以及死亡和依赖性（调整后的OR:.88，95%CI:.75-1.02）方面没有差异。结论：岛叶缺血性卒中受累的偏侧化与卒中结局无关。

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