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The prognostic factors that influence long-term survival in acute large cerebral infarction
Sung Yun Cho1, Chang Wan Oh, Hee-Joon Bae
1Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.
Insights
Age and functional outcome are key predictors of survival after large cerebral infarction. Younger patients and those with good functional recovery lived significantly longer. This study identifies critical prognostic factors for stroke survivors.
Area of Science:
- Neurology
- Stroke Medicine
- Clinical Prognostics
Background:
- Acute large cerebral infarction poses a significant threat to long-term survival.
- Identifying prognostic factors is crucial for managing stroke patients and improving outcomes.
Purpose of the Study:
- To retrospectively evaluate prognostic factors influencing long-term survival in patients with acute large cerebral infarction.
- To identify critical predictors of life expectancy in stroke survivors.
Main Methods:
- Retrospective analysis of 178 patients diagnosed with large cerebral infarction between June 2003 and October 2008.
- Focus on 122 patients alive one month post-stroke to investigate survival-influencing factors.
- Statistical analysis of demographic, clinical, and outcome data.
Main Results:
- Mean survival was 41.7 months; younger patients (<70 years) had significantly longer survival (58.9 months) than older patients (≥70 years, 29.7 months).
- Good functional outcome (mRS ≤3) correlated with longer survival (58.6 months) compared to poor outcome (mRS ≥4, 33.9 months).
- Involvement of Anterior Cerebral Artery (ACA) or Posterior Cerebral Artery (PCA) territory in Middle Cerebral Artery (MCA) infarction was a poor prognostic factor (p=0.021).
Conclusions:
- Age (younger than 70) and functional outcome at one month are critical prognostic factors for survival after acute large cerebral infarction.
- Territorial involvement (ACA or PCA) in MCA infarction indicates a poorer prognosis.
- Traditional risk factors like hypertension and diabetes did not significantly impact survival in this cohort.
Objective:
We retrospectively evaluated the prognostic factors that can influence long-term survival in patients who suffered acute large cerebral infarction.
Methods:
Between June 2003 and October 2008, a total of 178 patients were diagnosed with a large cerebral infarction, and, among them, 122 patients were alive one month after the onset of stroke. We investigated the multiple factors that might have influenced the life expectancies of these 122 patients.
Results:
The mean age of the patients was 70±13.4 years and the mean survival was 41.7±2.8 months. The mean survival of the poor functional outcome group (mRS≥4) was 33.9±3.3 months, whereas that of the good functional outcome group (mRS≤3) was 58.6±2.6 months (p value =0.000). The mean survival of the older patients (≥70 years) was 29.7±3.4 months, whereas that of the younger patients (<70 years) was much better as 58.9±3.2 months (p value=0.000). Involvement of ACA or PCA territory in MCA infarction is also a poor prognostic factor (p value=0.021). But, other factors that are also known as significant predictors of poor survival (male gender, hypertension, heart failure, atrial fibrillation, diabetes mellitus, a previous history of stroke, smoking, and dyslipidemia) did not significantly influence the mean survival time in the current study.
Conclusion:
Age (older versus younger than 70 years old) and functional outcome at one month could be critical prognostic factors for survival after acute large cerebral infarction. Involvement of ACA or PCA territory is also an important poor prognostic factor in patients with MCA territorial infarction.
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