| Item type |
文献 / Documents(1) |
| 公開日 |
2020-11-05 |
| アクセス権 |
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|
アクセス権 |
open access |
| 資源タイプ |
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|
資源タイプ識別子 |
http://purl.org/coar/resource_type/c_6501 |
|
資源タイプ |
journal article |
| 出版社版DOI |
|
|
|
識別子タイプ |
DOI |
|
|
関連識別子 |
https://doi.org/10.1159/000504163 |
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|
言語 |
ja |
|
|
関連名称 |
10.1159/000504163 |
| 出版タイプ |
|
|
出版タイプ |
VoR |
|
出版タイプResource |
http://purl.org/coar/version/c_970fb48d4fbd8a85 |
| タイトル |
|
|
タイトル |
Active Cancer and Elevated D-Dimer Are Risk Factors for In-Hospital Ischemic Stroke |
|
言語 |
en |
| タイトル別表記 |
|
|
その他のタイトル |
Progression to In-Hospital Ischemic Stroke |
|
言語 |
en |
| 著者 |
山口, 泉
兼松, 康久
島田, 健司
高麗, 雅章
宮本, 健志
シカタ, エイジ
ヤマグチ, タダシ
山本, 伸昭
山本, 雄貴
キタザト, ケイコ
オカヤマ, ヨシヒロ
高木, 康志
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| 抄録 |
|
|
内容記述タイプ |
Abstract |
|
内容記述 |
Background and Purpose: Little attention has been paid to the pathogenesis of in-hospital stroke, despite poor outcomes and a longer time from stroke onset to treatment. We studied the pathophysiology and biomarkers for detecting patients who progress to in-hospital ischemic stroke (IHS). Methods: Seventy-nine patients with IHS were sequentially recruited in the period 2011–2017. Their characteristics, care, and outcomes were compared with 933 patients who had an out-of-hospital ischemic stroke (OHS) using a prospectively collected database of the Tokushima University Stroke Registry. Results: Active cancer and coronary artery disease were more prevalent in patients with IHS than in those with OHS (53.2 and 27.8% vs. 2.0 and 10.9%, respectively; p < 0.001), the median onset-to-evaluation time was longer (300 vs. 240 min; p = 0.015), and the undetermined etiology was significantly higher (36.7 vs. 2.4%; p < 0.001). Although there was no significant difference in stroke severity at onset between the groups, patients with IHS had higher modified Rankin Scale (mRS) scores (3–6) at discharge (67.1 vs. 50.3%; p = 0.004) and rates of death during hospitalization (16.5 vs. 2.9%; p < 0.001). D-dimer (5.8 vs. 0.8 µg/mL; p < 0.001) and fibrinogen (532 vs. 430 mg/dL; p = 0.014) plasma levels at the time of onset were significantly higher in patients with IHS after propensity score matching. Multivariate logistic regression analysis revealed that active cancer (odds ratio [OR] 2.30; 95% confidence interval [CI] 1.26–4.20), prestroke mRS scores 3–5 (OR 6.78; 95% CI 3.96–11.61), female sex (OR 1.57; 95% CI 1.19–2.08), and age ≥75 years (OR 2.36; 95% CI 1.80–3.08) were associated with poor outcomes. Conclusions: Patients with IHS had poorer outcomes than those with OHS because of a higher prevalence of active cancer and functional dependence before stroke onset. Elevated plasma levels of D-dimer and fibrinogen, especially with active cancer, can help identify patients who are at a higher risk of progression to IHS. |
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言語 |
en |
| キーワード |
|
|
言語 |
en |
|
主題Scheme |
Other |
|
主題 |
In-hospital stroke |
| キーワード |
|
|
言語 |
en |
|
主題Scheme |
Other |
|
主題 |
Cancer |
| キーワード |
|
|
言語 |
en |
|
主題Scheme |
Other |
|
主題 |
D-dimer |
| キーワード |
|
|
言語 |
en |
|
主題Scheme |
Other |
|
主題 |
Fibrinogen |
| キーワード |
|
|
言語 |
en |
|
主題Scheme |
Other |
|
主題 |
Hypercoagulability |
| 書誌情報 |
en : Cerebrovascular Diseases Extra
巻 9,
号 3,
p. 129-138,
発行日 2019-11-22
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| 収録物ID |
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|
収録物識別子タイプ |
ISSN |
|
収録物識別子 |
16645456 |
| 出版者 |
|
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出版者 |
Karger |
|
言語 |
en |
| 権利情報 |
|
|
言語 |
en |
|
権利情報 |
This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND) . Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission. |
| EID |
|
|
識別子 |
363937 |
|
識別子タイプ |
URI |
| 言語 |
|
|
言語 |
eng |
cde_9_3_129.pdf (662 KB)
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