Right insular infarction and mortality after ischaemic stroke

Autor: Martin Ebinger, Jochen B. Fiebach, Ulrike Grittner, Kersten Villringer, L. Hanne, Matthias Endres, Peter Brunecker
Rok vydání: 2016
Předmět:
Male
Infarction
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
Functional Laterality
Brain Ischemia
0302 clinical medicine
Atrial Fibrillation
diagnostic imaging [Cerebral Cortex]
mortality [Stroke]
etiology [Stroke]
Cerebral Cortex
Aged
80 and over
medicine.diagnostic_test
Cerebral infarction
Hazard ratio
Atrial fibrillation
Cerebral Infarction
Middle Aged
Prognosis
Stroke
Neurology
behavior and behavior mechanisms
Cardiology
Female
medicine.symptom
psychological phenomena and processes
complications [Atrial Fibrillation]
medicine.medical_specialty
pathology [Brain Ischemia]
behavioral disciplines and activities
Lesion
03 medical and health sciences
Internal medicine
medicine
Humans
ddc:610
cardiovascular diseases
Aged
business.industry
Proportional hazards model
mortality [Cerebral Infarction]
Magnetic resonance imaging
medicine.disease
etiology [Brain Ischemia]
Survival Analysis
Confidence interval
Surgery
pathology [Cerebral Infarction]
etiology [Cerebral Infarction]
Diffusion Magnetic Resonance Imaging
nervous system
pathology [Stroke]
pathology [Cerebral Cortex]
Neurology (clinical)
business
030217 neurology & neurosurgery
Follow-Up Studies
Zdroj: European journal of neurology 24(1), 67-72 (2016). doi:10.1111/ene.13131
ISSN: 1351-5101
DOI: 10.1111/ene.13131
Popis: Background and purpose Several studies have described an association between insular infarction and mortality. Large infarcts often include the insula and lesion size is associated with mortality. We hypothesized that there is an association between insular infarction and mortality independent of lesion volume. Methods We included consecutive stroke patients between 1 September 2008 and 11 November 2012 from the 1000Plus database with an acute ischaemic lesion on diffusion-weighted imaging on day 1 and a completed 90-day follow-up. Insular infarct location was determined using the in-house software Stroke Lesion Atlas. In multiple Cox regression analysis (dependent variable: mortality), we adjusted for insular infarcts, age, lesion volume, history of atrial fibrillation, National Institutes of Health Stroke Scale and previous stroke. Results We included 736 patients, of whom 168 had an insular infarction. Within a medium follow-up time of 107 days, cumulative survival was 90% in patients with insular infarction and 99% in patients without insular infarction (P < 0.001). Right insular infarction was independently associated with mortality (hazard ratio, 2.60; confidence interval, 1.3–5.4; P = 0.010). Conclusions In our study, right insular involvement was a prognostic marker for mortality after ischaemic stroke. A selection bias towards patients able to give informed consent warrants further studies.
Databáze: OpenAIRE
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