TOAST Distribution of Ischemic Stroke Patients Admitted to Oriental Hospitals

한방 의료기관에 입원한 허혈성 뇌졸중 환자의 아형 분포

  • Lee, Jung-Sup (Division of TKM Integrated Research Brain Disease Research Center, Korea Institute of Oriental Medicine) ;
  • Ko, Mi-Mi (Division of TKM Integrated Research Brain Disease Research Center, Korea Institute of Oriental Medicine) ;
  • Lee, Ju-Ah (Division of TKM Integrated Research Brain Disease Research Center, Korea Institute of Oriental Medicine) ;
  • Kang, Byoung-Kab (Division of TKM Integrated Research Brain Disease Research Center, Korea Institute of Oriental Medicine) ;
  • Cha, Min-Ho (Division of TKM Integrated Research Brain Disease Research Center, Korea Institute of Oriental Medicine) ;
  • Oh, Dal-Seok (Division of TKM Integrated Research Brain Disease Research Center, Korea Institute of Oriental Medicine) ;
  • Bang, Ok-Sun (Division of TKM Integrated Research Brain Disease Research Center, Korea Institute of Oriental Medicine)
  • 이정섭 (한국한의학연구원 융합연구본부 뇌질환연구센터) ;
  • 고미미 (한국한의학연구원 융합연구본부 뇌질환연구센터) ;
  • 이주아 (한국한의학연구원 융합연구본부 뇌질환연구센터) ;
  • 강병갑 (한국한의학연구원 융합연구본부 뇌질환연구센터) ;
  • 차민호 (한국한의학연구원 융합연구본부 뇌질환연구센터) ;
  • 오달석 (한국한의학연구원 융합연구본부 뇌질환연구센터) ;
  • 방옥선 (한국한의학연구원 융합연구본부 뇌질환연구센터)
  • Received : 2010.06.09
  • Accepted : 2010.09.02
  • Published : 2010.09.30

Abstract

Objectives: The aim of this study was to determine distribution patterns of TOAST subtypes of ischemic stroke patients admitted to oriental hospitals and to get a better understanding of present conditions in oriental medicine by comparing with the Korea stroke registry (KSR), the largest and representative data. Methods: Clinical data were collected from acute ischemic stoke patients. MRI studies including vascular images were performed in all cases. TOAST criteria were used to determine subtypes of ischemic stroke patients. According to the duration from disease onset to hospital admission time, patients were assigned to 3 groups (Group I0 to 3 d, Group II4 to 7 d, Group III8 to 28 d) and the distribution of TOAST subtypes were compared among these three groups. Results: We collected 514 sets of clinical data from 10 oriental hospitals between May 2007 and September 2009. Small vessel occlusion (SVO) subtype was the most common (57.62%), followed by large artery atherosclerosis (LAA, 29.98%). Compared with TOAST distribution of KSR, the proportion of ischemic stroke patients with SVO subtype was higher than that of KSR. On the other hand the proportion of patients with stroke of undetermined etiology (SUE) was lower. Distributions of SVO, LAA and cardioembolism (CE) in group were I 66.4%, 23.8% and 8.9%, respectively; those in group IIIwere 51.03%, 34.71% and 11.57%, respectively. Conclusions: In oriental hospitals, the proportion of ischemic stroke patients diagnosed as SVO type was higher than that of KSR. At early stage (from onset to 2 d) proportion of SVO was very high, however after 7 days from onset it decreased with concomitant increases in proportions of LAA and CE. These phenomena may be due to the facts that 1) at early stage emergency treatments are limited in oriental hospitals, 2) after early stage many patients prefer oriental treatments, including rehabilitation.

Keywords

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