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Journal of the Korean Geriatrics Society 2001;5(2):167-176.
Published online June 30, 2001.
Mortality Rate and Early Prognostic Factors In Patients With Severe
Harry Na, Woo Youl Kang, Seung Cheol Jeong, Kyung Ho Yu, Hyeo Il Ma, Byung Chul Lee
중증 대뇌반구경색 환자의 사망률과 초기 예후인자
Abstract
BACKGROUND
& OBJECTIVES: Severe hemispheric infarction(SHI) reportedly has various range of high mortality. Recently it has been reported that more aggressive therapeutic intervention, such as decompressive hemicraniectomy or mild hypothermia might has potential benefits in the management of SHI. However, the mortality and the prognosis of Sill under the conservative treatment were rarely studied yet in Korea.
METHODS
Sixty-six patients with CT proven SHI were subjected among 1649 acute stroke patients registered at the Hallym Stroke Data Bank since Jan. 1993. We analyzed the computerized databases for the mortality and compared inclusively demographic features, clinical characteristics, etiology, therapy modalities and CT findings of fatal group with those of survivors.
RESULTS
Twenty-five patients were expired among 66 SI-il patients(mean age: 64.9+/-11.5, male to female ratio;37:29). The mean time to expire was 160.4 hours. The fatal group had a significantly higher incidence of cardioembolism. uncontrolled BP during the acute stage, and extensive infarction territory(MCA+ACA). Risk factors for ischemic stroke such as hypertension, hyperlipidemia. smoking, previous stroke history, diabetes mellitus. and old age were not related to mortality low densities and hyperdense MCA signs on brain imaging were not different between two groups.
CONCLUSIONS
The early mortality rate of Sill under the conservative care was 38% in a referral hospital of Korea. intractable hypertension in the acute stage, cardioembolism and extent of infarct area may have predictable values of early mortality of SHI.
Key Words: Hemispheric infarct, Mortality, prognosis


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