scholarly journals Intracranial Atherosclerosis in Stroke Patients, Which Risk Factors Are Important? A Study From Mixed Ethnic Population in Singapore.

2021 ◽  
Author(s):  
shrikant Pande ◽  
May Thiri Lwin ◽  
Aye Aye Khine ◽  
May Win Myat ◽  
Lorecar Lolong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariable Analysis ◽  
Large Artery ◽  
Intracranial Atherosclerosis ◽  
Stroke Patients ◽  
Term Survival ◽  
Significant Stenosis ◽  
Proactive Management ◽  
History Of

Abstract Intracranial atherosclerosis (ICAD) although more common in Asians, has not been studied from Singapore population. The aim of this study is to identify prevalence ICAD in stroke subjects, its association with comorbidities, stroke subtypes and long-term survival. We performed retrospective analysis of 681 stroke patients, 327(48%) had ICAD) with 232 (71%) having one or more intracranial artery with significant stenosis. ICAD was associated with older age, ischaemic strokes, total anterior circulation syndrome (TACS), large artery strokes (p<0.001), peripheral vascular disease (PVD, p=0.018), diabetes mellitus (DM), and with history of hyperlipidemia. In addition, higher serum potassium (p=0.046) and glucose (p<0.001), lower haemoglobin (p=0.040) and aortic valve sclerosis were significantly associated with ICAD (p<0.001). Multivariable analysis showed a significant independent association of ICAD with advancing age, history of hyperlipidemia and DM.In ischemic strokes (489), 311(64%) had ICAD of which 229(72%) had significant stenosis. Of the 192 hemorrhagic strokes, 16 (8%) had ICAD.Conclusion: The prevalence of ICAD, especially in ischemic strokes, from our study is high. As modifiable risk factors such as hyperlipidemia and DM appear to be associated with ICAD, then proactive management of these conditions may improve long term associated complications. Prospective studies may help to validate our findings.

The influence of thrombophilia on the long-term survival of patients with a history of venous thromboembolism

2013 ◽  
Vol 109 (01) ◽  
pp. 79-84 ◽  
Author(s):  
Sylvia Reitter-Pfoertner ◽  
Thomas Waldhoer ◽  
Michaela Mayerhofer ◽  
Ernst Eigenbauer ◽  
Cihan Ay ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Multivariable Analysis ◽  
Factor V Leiden ◽  
Arterial Disease ◽  
Factor V ◽  
Term Survival ◽  
Long Term Survival ◽  
History Of

SummaryData on the long-term survival following venous thromboembolism (VTE) are rare,and the influence of thrombophilia has not been evaluated thus far. Our aim was to assess thrombophilia-parameters as predictors for long-term survival of patients with VTE. Overall, 1,905 outpatients (99 with antithrombin-, protein C or protein S deficiency, 517 with factor V Leiden, 381 with elevated factor VIII and 160 with elevated homocysteine levels, of these 202 had a combination and 961 had none of these risk factors) were included in the study between September 1, 1994 and December 31, 2007. Retrospective survival analysis showed that a total of 78 patients (4.1%) had died during the analysis period, among those four of definite or possible pulmonary embolism and four of bleeding. In multivariable analysis including age and sex an association with increased mortality was found for hyperhomocysteinemia (hazard ratio 2.0 [1.1.-3.5]) whereas this was not the case for all other investigated parameters. We conclude that the classical hereditary thrombophilia risk factors did not have an impact on the long-term survival of patients with a history of VTE. Thus our study supports the current concept that thrombophilia should not be a determinant for decision on long term anticoagulation. However, hyperhomocysteinaemia, known as a risk factor for recurrent VTE and arterial disease, might impact survival.

scholarly journals Risk factors for anastomotic leakage and its impact on long-term survival in left-sided colorectal cancer surgery

2020 ◽  
Author(s):  
Marius Kryzauskas ◽  
Augustinas Bausys ◽  
Austeja Elzbieta Degutyte ◽  
Vilius Abeciunas ◽  
Eligijus Poskus ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Rectal Resection ◽  
Multivariable Analysis ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Long Term Survival ◽  
Male Sex ◽  
The Impact

Abstract Background: Anastomotic leakage (AL) significantly impairs short-term outcomes. The impact on the long-term outcomes remains unclear. This study aimed to identify the risk factors for AL and the impact on long-term survival in patients with left-sided colorectal cancer.Methods: Nine-hundred patients with left-sided colorectal carcinoma who underwent sigmoid or rectal resection were enrolled in the study. Risk factors for AL after sigmoid or rectal resection were identified and long-term outcomes of patients with and without AL were compared.Results: AL rates following sigmoid and rectal resection were 5.1% and 10.7%, respectively. Higher ASA score (III-IV; OR=10.54, p=0.007) was associated with AL in patients undergoing sigmoid surgery on multivariable analysis. Male sex (OR=2.40, p=0.004), CCI score >5 (OR=1.72, p=0.025) and T3/T4 stage tumors (OR=2.25, p=0.017) were risk factors for AL after rectal resection on multivariable analysis. AL impaired disease-free and overall survival in patients undergoing sigmoid (p=0.009 and p=0.001) and rectal (p=0.003 and p=0.014) surgery.Conclusion: ASA score of III-IV is an independent risk factor for AL after sigmoid surgery and male sex, higher CCI score, and advanced T stage are risk factors for AL after rectal surgery. AL impairs the long-term survival in patients undergoing left-sided colorectal surgery.

Abstract TP109: Multiplicity of Atherosclerotic Risk Factors Predicts a Risk of Large Arterial Atherosclerosis and Long-term Mortality in Patients with Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Sungho Ahn ◽  
Eun-Jae Lee ◽  
Dong-Wha Kang ◽  
Sun U. Kwon ◽  
Jong S. Kim
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Baseline Risk ◽  
Large Artery ◽  
Stroke Patients ◽  
Atherosclerotic Burden ◽  
Point Increase ◽  
Atherosclerotic Risk Factors ◽  
Long Term Mortality

Background: The aim of this study was to investigate clinical significance of multiplicity of atherosclerotic risk factors to determine the type of stroke and long-term mortality in patients with large artery atherosclerotic (LAA) and small vessel occlusive (SVO) stroke. Methods: We retrospectively analyzed medical data of the prospectively registered stroke patients who were diagnosed as LAA and SVO type of ischemic stroke based on diffusion weighted MRI and magnetic resonance angiography between January 2005 and December 2013. Multiplicity of risk factors was defined as numbers of hypertension, diabetes, hyperlipidemia and smoking. Information on mortality as outcome was obtained and reconfirmed from the National Death Certificate system. Results: A total of 4099 patients comprising 2530 LAA stroke and 1569 SVO stroke were studied. After adjustment for differences in baseline risk profiles, multiplicity of risk factors (per 1-point increase, odds ratio [OR] = 1.10, 95% confidence interval [CI] = 1.02-1.18) was significantly associated with the LAA stroke than SVO stroke. Among patients with SVO stroke, patients with a higher multiplicity of risk factors had a higher long-term mortality (OR = 1.34, 95% CI = 1.10-1.65) during 8-year of observation. Conclusions: Atherosclerotic burden defined by multiplicity of risk factors for atherosclerosis could predict the probability of developing LAA stroke compared to the SVO stroke, and long-term mortality particularly in SVO stroke.

scholarly journals Long-term survival after Carpentier-Edwards Perimount aortic valve replacement in Western Denmark: a multi-centre observational study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lytfi Krasniqi ◽  
Mads P. Kronby ◽  
Lars P. S. Riber
Keyword(s):  
Risk Factors ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Significant Risk ◽  
Valve Prosthesis ◽  
Term Survival ◽  
Long Term Survival ◽  
All Cause Mortality

Abstract Background This study describes the long-term survival, risk of reoperation and clinical outcomes of patients undergoing solitary surgical aortic valve replacement (SAVR) with a Carpentier-Edwards Perimount (CE-P) bioprosthetic in Western Denmark. The renewed interest in SAVR is based on the questioning regarding the long-term survival since new aortic replacement technique such as transcatheter aortic-valve replacement (TAVR) probably have shorter durability, why assessment of long-term survival could be a key issue for patients. Methods From November 1999 to November 2013 a cohort of a total of 1604 patients with a median age of 73 years (IQR: 69–78) undergoing solitary SAVR with CE-P in Western Denmark was obtained November 2018 from the Western Danish Heart Registry (WDHR). The primary endpoint was long-term survival from all-cause mortality. Secondary endpoints were survival free from major adverse cardiovascular and cerebral events (MACCE), risk of reoperation, cause of late death, patient-prothesis mismatch, risk of AMI, stroke, pacemaker or ICD implantation and postoperative atrial fibrillation (POAF). Time-to-event analysis was performed with Kaplan-Meier curve, cumulative incidence function was performed with Nelson-Aalen cumulative hazard estimates. Cox regression was applied to detect risk factors for death and reoperation. Results In-hospital mortality was 2.7% and 30-day mortality at 3.4%. The 5-, 10- and 15-year survival from all-cause mortality was 77, 52 and 24%, respectively. Survival without MACCE was 80% after 10 years. Significant risk factors of mortality were small valves, smoking and EuroSCORE II ≥4%. The risk of reoperation was < 5% after 7.5 years and significant risk factors were valve prosthesis-patient mismatch and EuroSCORE II ≥4%. Conclusions Patients undergoing aortic valve replacement with a Carpentier-Edwards Perimount valve shows a very satisfying long-term survival. Future research should aim to investigate biological valves long-term durability for comparison of different SAVR to different TAVR in long perspective.

scholarly journals Impacts of treatments on recurrence and 28-year survival of ischemic stroke patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ting-Ann Wang ◽  
Tzy-Haw Wu ◽  
Shin-Liang Pan ◽  
Hsiu-Hsi Chen ◽  
Sherry Yueh-Hsia Chiu
Keyword(s):  
Ischemic Stroke ◽  
Cerebrovascular Disease ◽  
Cox Regression ◽  
Controlled Trial ◽  
Stroke Recurrence ◽  
Long Term Effects ◽  
Stroke Patients ◽  
Double Blind ◽  
Term Survival

AbstractAspirin and nicametate are well-established therapies for preventing recurrence and mortality from stroke in patients diagnosed as ischemic stroke. However, their respective effects on the recurrence, making allowance for the duration of recurrence and death without the occurrence of recurrence, and long-term survival have not been well elucidated. We aimed to evaluate long-term effect of two kinds of treatment on cerebrovascular death among ischemic stroke patients with or without the recurrence of stroke. Data used in this study were derived from the cohort based on a multicenter randomized double-blind controlled trial during 1992 to 1995 with the enrollment of a total of 466 patients with first-time non-cardioembolic ischemic stroke who were randomly allocated to receive aspirin (n = 222) or nicametate (n = 244). The trial cohort was followed up over time to ascertain the date of recurrence within trial period and death until Sep of 2019. The time-dependent Cox regression model was used to estimate the long-term effects of two treatments on death from cerebrovascular disease with and without recurrence. A total of 49 patients experienced stroke recurrence and 89 cerebrovascular deaths was confirmed. Patients treated with nicametate were more likely, but non statistically significantly, to have recurrence (aHR: 1.73, 95% CI 0.96–3.13) as compared with those treated by aspirin. Nicametate reduced the risk of cerebrovascular death about 37% (aHR: 0.63, 95% CI 0.41–0.97) compared with aspirin. The aspirin group had a lower recurrence rate than the nicametate group even with recurrence after 1–2 years of follow-up of first stroke but the latter had significantly reduced death from cerebrovascular disease for nicametate group, which requires more research to verify.

scholarly journals Analysis of Sociodemographic and Clinical Factors Associated with Hospitalized Stroke Patients of Bangladesh

1970 ◽  
Vol 6 (1) ◽  
pp. 19-23 ◽  
Author(s):  
AM Hossain ◽  
NU Ahmed ◽  
M Rahman ◽  
MR Islam ◽  
G Sadhya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Low Income ◽  
Heart Diseases ◽  
Previous History ◽  
Stroke Patients ◽  
College Hospital ◽  
Cross Sectional ◽  
History Of

A hospital based cross sectional study was carried out to analyze prevalence of risk factors for stroke in hospitalized patient in a medical college hospital. 100 patients were chosen using purposive sampling technique. Highest incidence of stroke was between the 6th and 7th decade. Patients came from both urban (54%) and rural (46%) areas and most of them belong to the low-income group (47%). In occupational category; service holder (28%) and retired person (21%) were the highest groups. Most of the study subjects were literate (63%). CT scan study revealed that the incidence of ischaemic stroke was 61% and haemorrhagic stroke 39%. Analysis indicated hypertension as major risk factor for stroke (63%) and major portion of the patients (42.85%) were on irregular or no treatment. Twenty four percent of the patients had heart diseases and out of 24 patients 45.83% were suffering from ischaemic heart disease. The present study detected diabetes in 21% patients. Fifty three percent of the study subjects were smoker, 39% patients had habit of betelnut chewing. Out of 26 female patients, only 23% had history of using oral contraceptives. Majority of the patients were sedentary workers (46%). Thirty seven percent of the stroke patients were obese. Among the stroke patients 9% had previous history of stroke and 3% had TIA respectively. Most of the patients (21%) were awake while they suffered from stroke and the time of occurrence was mostly in the afternoon (46%). This study found that hypertension, cigarette smoking, ischaemic heart disease and diabetes mellitus are the major risk factors prevalent in our community while other risk factors demand further study. Key words: stroke; risk factors; hospitalized patients; Bangladesh. DOI: 10.3329/fmcj.v6i1.7405 Faridpur Med. Coll. J. 2011;6(1): 19-23

Long-Term Survival of a Patient with Hepatocellular Carcinoma under Treatment with Viscum album – Case Report

2021 ◽  
pp. 237-243
Author(s):  
Ana Catarina Viana Valle ◽  
Aloísio Cunha de Carvalho
Keyword(s):  
Hepatocellular Carcinoma ◽  
Tumor Growth ◽  
Liver Neoplasm ◽  
Viscum Album ◽  
Health Condition ◽  
Continuous Treatment ◽  
Term Survival ◽  
History Of ◽  
Application Frequency

Hepatocellular carcinoma (HCC) is the most common liver neoplasm in dogs and can be treated by the Viscum album therapy in a curative or palliative way. The objective is to report a hepatocellular carcinoma case in a dog treated by homeopathic therapy, extending to Palliative Care, with a 24-month survival. A 12-year-old Schnauzer male with a history of a liver nodule was treated by intravenous and subcutaneous applications of V. album in different dynamization and combinations, chromotherapy, and oral homeopathic medicines. The tumor growth was controlled, and the health condition of the patient was stable while the medication was given as prescribed. However, as application frequency was reduced, tumor growth increased, and health deterioration was verified. Nevertheless and contrary to expectations, the patient had a 24-month survival. Therefore, these findings point to the potential of V. album on enhancing the quality of life, controlling tumor growth, and prolonging survival on patients with HCC. Patients under continuous treatment would benefit better of these properties.

The Risk of Seizure Recurrence After a First Unprovoked Afebrile Seizure in Childhood: An Extended Follow-up

PEDIATRICS ◽  
1996 ◽  
Vol 98 (2) ◽  
pp. 216-225 ◽  
Author(s):  
Shlomo Shinnar ◽  
Anne T. Berg ◽  
Solomon L. Moshe ◽  
Christine O'Dell ◽  
Marta Alemany ◽  
...  
Keyword(s):  
Risk Factors ◽  
Age Of Onset ◽  
Multivariable Analysis ◽  
Cumulative Risk ◽  
Febrile Seizures ◽  
Recurrence Risk ◽  
Early Recurrence ◽  
Seizure Recurrence ◽  
Unprovoked Seizure ◽  
History Of

Objective. To assess the long-term recurrence risks after a first unprovoked seizure in childhood. Methods. In a prospective study, 407 children who presented with a first unprovoked seizure were then followed for a mean of 6.3 years from the time of first seizure. Results. One hundred seventy-one children (42%) experienced subsequent seizures. The cumulative risk of seizure recurrence was 29%,37%,42%, and 44% at 1,2,5, and 8 years, respectively. The median time to recurrence was 5.7 months, with 53% of recurrences occurring within 6 months, 69% within 1 year, and 88% within 2 years. Only 5 recurrences (3%) occurred after 5 years. On multivariable analysis, risk factors for seizure recurrence included a remote symptomatic etiology, an abnormal electroencephalogram (EEG), a seizure occurring while asleep, a history of prior febrile seizures, and Todd's paresis. In cryptogenic cases, the risk factors were an abnormal EEG and an initial seizure during sleep. In remote symptomatic cases, risk factors were a history of prior febrile seizures and age of onset younger than 3 years. Risk factors for late recurrences (after 2 years) were etiology, an abnormal EEG, and prior febrile seizures in the overall group and an abnormal EEG in the cryptogenic group. These are similar to the risk factors for early recurrence. Conclusions. The majority of children with a first unprovoked seizure will not have recurrences. Children with cryptogenic first seizures and a normal EEG whose initial seizure occurs while awake have a particularly favorable prognosis, with a 5-year recurrence risk of only 21%. Late recurrences do occur but are uncommon.

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