18歳から50歳までの成人の脳卒中後の長期的な死亡率
Loes C A Rutten-Jacobs1, Renate M Arntz, Noortje A M Maaijwee
1Department of Neurology, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands.
JAMA
|March 21, 2013
まとめ
脳卒中を経験した若年成人では,長期的な死亡リスクが著しく高まります. この研究では,18歳から50歳までの個人の急性脳卒中後の20年間の死亡率は,一般の人々と比較して大幅に上昇したことが判明しました.
科学分野:
- 神経学 神経学とは
- 公衆衛生は公衆衛生である.
- エピデミオロジー エピデミオロジー
背景:
- 若い成人 (18~50歳) の初めての脳卒中後の長期的な死亡率は限られているが,特に非発血性脳卒中については限られている.
- 以前の研究では,予想される死亡率はしばしば除外され,脳卒中特有のリスクを過大評価している可能性がある.
研究 の 目的:
- 18歳から50歳までの成人の急性脳卒中後の長期的な死亡率と死因を調査する.
- 観察された死亡率と,年齢と性別を合わせた全国の死亡率を比較する.
主な方法:
- 前向きコホート研究 (FUTURE研究) は,史上初の短期間性心血管梗塞 (TIA),心血管梗塞,脳内出血を患った959人の患者を対象に実施された.
- 平均11.1年の追跡期間における生存状態の評価,標準化された死亡率 (SMRs) を用いて観察された死亡率と予想される死亡率を比較した.
主要な成果:
- 30日間の生存者における20年間の累積死亡率は,TIAでは24.9%,不全性脳卒中では26.8%,脳内出血では13.7%でした.
- 観察された死亡率は予想よりも大幅に高く,SMRは2.6 (TIA) から3.9 (脳卒中と脳内出血) であった.
- 発血性脳卒中の死亡リスクは,女性よりも男性で高かった.
結論:
- 若い成人 (18-50歳) は,一般の人々と比較して,急性脳卒中後の20年間の死亡リスクが比較的高くなります.
- 研究結果は,若い脳卒中生存者における二次予防戦略の強化の必要性を強調しています.
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