18歳から49歳までの成人の脳卒中と長期的な死亡率との関連
Merel Sanne Ekker1, Jamie Inge Verhoeven1, Ilonca Vaartjes2
1Radboud University Medical Centre, Donders Institute for Brain, Cognition, and Behaviour, Department of Neurology, Nijmegen, the Netherlands.
JAMA
|May 24, 2019
まとめ
最初の脳卒中を経験した若者は,その15年後の死亡リスクが高くなります. この研究は,若年層における脳卒中の危険性を強調し,継続的なモニタリングと研究の必要性を強調しています.
科学分野:
- 神経学
- 公衆衛生
- 流行病学
背景:
- 脳卒中は世界の主要な死因で 若年層の割合が大きいのです
- 特に若年脳卒中生存者の長期的な予後と死亡率に関するデータは限られている.
研究 の 目的:
- 最初の脳卒中後に若い成人 (18~49歳) の短期および長期の死亡リスクを評価する.
- 年齢,性別,脳卒中のサブタイプによって層分かれ,死亡傾向と死因を分析する.
- 脳卒中を生き延びた若者の死亡率を 一般の人々と比較する
主な方法:
- オランダでの登録と集団ベースの研究で,18歳から49歳の初回の脳卒中患者1万527人 (1998年−2010年) が参加した.
- 2017年1月1日までの患者識別と結果追跡のためのデータリンク
- 主なアウトカム: 一般人群と比較して30日間の生存者の全因死亡率.
主要な成果:
- 30日間の生存者の15年間の死亡率は17.0%でした.
- 標準化された死亡率は一般人よりもかなり高かった. 血栓性脳卒中では5. 1%,脳内出血では8. 4.
- 1000人年あたりの過剰死亡率は,不全性脳卒中では9. 6,脳内出血では16. 4であった.
結論:
- 脳卒中を生き延びた若い成人は,脳卒中後15年間,継続的に高い死亡リスクを経験します.
- この高いリスクは,様々な脳卒中サブタイプで,一般集団と比較して明らかです.
- 発見は,若者の脳卒中の集中的な研究と管理戦略の必要性を強調しています.
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