一般住民における脳卒中の長期予後と死亡の危険因子に関する検討:久山町研究

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Background and Purpose: There have been relatively few population-based studies of long-termprognosis and risk factors for death after stroke. We evaluated the 10-year prognosisof stroke, causes of death and risk factors for death (only cerebral infarction group) in aJapanese rural community,Hisayama.Methods: The study cohort consisted of 333 patients with stroke (cerebral infarction (CI) in244, intracerebral hemorrhage (ICH) in 60 and subarachnoid hemorrhage (SAH) in 29), whooccurred among 1,621 Hisayama residents aged 40 years or older during the 26-year followupof a prospective study since 1961. To elucidate the risk factors for death in CI group, wecollected the data from the regular health checks within two years of onset. We set up thecontrol group which was consisted of free of stroke in our prospective study and attendanceat the health checks in 1973 or 1974.Results: Calculating age adjusted survival curves by Cox proportional-hazards analysis, CIgroup's curve declined gradually both men and women. In contrast, ICH and SAH group'scurve dropped radically in acute period. Any type of stroke group's mortality was higherthan the age-adjusted control group. Evaluating the causes of death by type, CI was mostfrequent and pneumonia and neoplasm were the next to CI in CI group. While, most ICHand SAH group died of original type of stroke, and neoplasm was most frequent in controlgroup. Multivariate analysis showed that age and low body mass index were significantly(p<0.05), and glucose intolerance was marginally (p<0.1) independent risk factors for death inCI group.Conclusion: To improve the long-term prognosis of stroke, the correction of glucose intolerancemay be important for CI group in chronic period, in addition to the cure in acute period.Because of the high mortality in acute period, the prevention of the occurrence may need forICH and SAH group.
2007-12-15

一般住民における脳卒中の長期予後と死亡の危険因子に関する検討:久山町研究

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