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What are the Predictors of Death in Patients With Cranio-Cervical Artery Dissection?

Yüksel Kaplan1, Özden Kamişli1, Sibel Altinayar1

  • 1Department of Neurology, İnönü University Faculty of Medicine, Malatya, Turkey.

Noro Psikiyatri Arsivi
|April 1, 2017
PubMed

Insights

Severe disability at admission is a key predictor of mortality in patients with cranio-cervical artery dissections (CCAD), including carotid artery dissection (CAD) and vertebral artery dissection (VAD). Hypertension and hypercholesterolemia also independently increase mortality risk in CCAD patients.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Clinical Research

Background:

  • Cranio-cervical artery dissections (CCAD) are rare but serious conditions.
  • Predictive factors for in-hospital mortality in CCAD patients are not well-established.
  • This study investigates mortality predictors in CCAD and its subgroups: carotid artery dissection (CAD) and vertebral artery dissection (VAD).

Purpose of the Study:

  • To identify predictors of in-hospital mortality in patients diagnosed with CCAD.
  • To analyze mortality-related prognostic factors in CAD and VAD subgroups.
  • To determine the association of clinical presentation, dissection location, risk factors, and patient demographics with CCAD mortality.

Main Methods:

  • Retrospective review of 67 patients with CAD or VAD admitted between 2000 and 2013.
  • Analysis of age, gender, modified Rankin Scale scores, clinical presentation, dissection location, risk factors, and treatments.
  • Comparison of prognostic characteristics between surviving and deceased CCAD patients, including CAD and VAD subgroups.

Main Results:

  • Mortality was observed in 17.9% of CCAD patients (5.46% with CAD, 10.44% with VAD).
  • Independent mortality predictors in CCAD and VAD included age >45 years, severe disability at admission, stroke presentation, and intracranial VAD.
  • Severe disability at admission was the sole mortality predictor in CAD, while hypertension and hypercholesterolemia were independent predictors in CCAD.

Conclusions:

  • Severe disability at admission is a significant mortality predictor for both CAD and VAD.
  • This study highlights the critical role of initial stroke severity and patient disability in predicting mortality outcomes for CCAD.
  • Hypertension and hypercholesterolemia are identified as independent mortality risk factors in the broader CCAD population.
Abstract

Keywords:
Cranio-cervical artery dissectioncarotid artery dissectionmortalitypredictorvertebral artery dissection

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