Risk Factors for Long-Term Death After Medullary Infarction: A Multicenter Follow-Up Study

Area of Science:

• Neurology
• Vascular Neurology
• Stroke Medicine

Background:

• Medullary infarction (MI) poses significant long-term risks, including poor prognosis and mortality.
• Identifying specific risk factors is crucial for improving patient outcomes and management strategies.

Purpose of the Study:

• To investigate the risk factors associated with death and poor long-term outcomes in patients with medullary infarction.
• To analyze clinical and radiological features correlating with adverse events following MI.

Main Methods:

• Retrospective analysis of 179 patients with confirmed medullary infarction.
• Long-term outcomes assessed via telephonic interviews, with analysis of clinical and radiological data.
• Risk factors for poor prognosis (modified Rankin scale score ≥ 3) and all-cause death were evaluated.

Main Results:

• 21.2% of patients experienced poor long-term prognosis; 10.6% mortality rate.
• Risk factors for poor prognosis included age ≥ 65, recurrent stroke, dysphagia, >50% basilar artery stenosis, and ventral MI.
• Age ≥ 65, recurrent stroke, and dysphagia were identified as significant risk factors for long-term death.

Conclusions:

• Long-term adverse outcomes and mortality are common following medullary infarction.
• Older age, history of recurrent stroke, and dysphagia are key predictors of poor prognosis and death.
• Ventral MI and artery-to-artery embolism were potential risk factors for mortality, with pneumonia and recurrent stroke as primary causes of death.