Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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The Prognostic Factors That Influence Long-Term Survival in Acute Large Cerebral Infarction

  • Cho, Sung-Yun (Department of Neurosurgery, Seoul National University Bundang Hospital) ;
  • Oh, Chang-Wan (Department of Neurosurgery, Seoul National University Bundang Hospital) ;
  • Bae, Hee-Joon (Department of Neurology, Seoul National University Bundang Hospital) ;
  • Han, Moon-Ku (Department of Neurology, Seoul National University Bundang Hospital) ;
  • Park, Hyun (Department of Neurosurgery, Seoul National University Bundang Hospital) ;
  • Bang, Jae-Seung (Department of Neurosurgery, Seoul National University Bundang Hospital)
  • Received : 2010.11.24
  • Accepted : 2011.02.04
  • Published : 2011.02.28
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Abstract

Objective : We retrospectively evaluated the prognostic factors that can influence long-term survival in patients who suffered acute large cerebral infarction. Methods : Between June 2003 and October 2008, a total of 178 patients were diagnosed with a large cerebral infarction, and, among them, 122 patients were alive one month after the onset of stroke. We investigated the multiple factors that might have influenced the life expectancies of these 122 patients. Results : The mean age of the patients was $70{\pm}13.4$ years and the mean survival was $41.7{\pm}2.8$ months. The mean survival of the poor functional outcome group ($mRS{\geq}4$) was $33.9{\pm}3.3$ months, whereas that of the good functional outcome group ($mRS{\leq}3$) was $58.6{\pm}2.6$ months (p value=0.000). The mean survival of the older patients (270 years) was $29.7{\pm}3.4$ months, whereas that of the younger patients (<70 years) was much better as $58.9{\pm}3.2$ months (p value=0.000). Involvement of ACA or PCA territory in MCA infarction is also a poor prognostic factor (p value=0.021). But, other factors that are also known as significant predictors of poor survival (male gender, hypertension, heart failure, atrial fibrillation, diabetes mellitus, a previous history of stroke, smoking, and dyslipidemia) did not significantly influence the mean survival time in the current study. Conclusion : Age (older versus younger than 70 years old) and functional outcome at one month could be critical prognostic factors for survival after acute large cerebral infarction. Involvement of ACA or PCA territory is also an important poor prognostic factor in patients with MCA territorial infarction.

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