| 제목 |
Factors associated with improvement or decline in cognitive function after hemorrhagic stroke |
| 소속 |
Pusan National University Yangsan Hospital, Department of Rehabilitation Medicine1, Severance Hospital, Department of Rehabilitation Medicine2, Chonnam National University Hospital, Department of Rehabilitation Medicine3, Konkuk University Medical Center, Department of Rehabilitation Medicine4, Chonnam National University Hospital, Department of Rehabilitation Medicine5, Kyungpook National University Hospital, Department of Rehabilitation Medicine6, Jeju National University Hospital, Department of Rehabilitation Medicine7, Wonkwang University School of Medicine & Hospital, Department of Rehabilitation Medicine8, Hallym University, Department of Statistics9, Samsung Medical Center, Department of Rehabilitation Medicine10 |
| 저자 |
Ji Hong Min1*, Ju Hyun Son1, Deog Young Kim2, Min Kyun Sohn3, Jongmin Lee4, Sam-Gyu Lee5, Yang-Soo Lee6, Eun Young Han7, Min Cheol Joo8, Gyung-Jae Oh8, Junhee Han9, Won Hyuk Chang10, Yun-Hee Kim10, Yong-Il Shin1† |
Objective: To identify the prevalence of delayed cognitive impairment; patients progress to either converter, stable, or reverter group after hemorrhagic stroke and clinical and demographic factors associated with improvement or decline in cognitive function between 3 months and 12 months after hemorrhagic stroke.
Methods: We analyzed the cognitive assessments of total patients and patients older than 65 years separately. All patients with an hemorrhagic stroke were divided into normal cognitive group (NCG) and impaired cognition group (ICG) by using a cutoff score on the Korean Mini-Mental State Examination (K-MMSE). Patients were additionally classified into 3 subgroups according to the changes in their K-MMSE scores between 3 and 12 months: Stable group with K-MMSE scores changes ranging from −2 to +2 points (−2 ≤ △MMSE ≤ +2); converter group with increase more than 3 points (3 ≤ △MMSE); and reverter group with decrease more than 3 points (−3 ≤ △MMSE). We also analyzed factors affecting cognitive change from 3 months to 12 months among the 3 groups including baseline medical record, stroke and treatment characteristics, and various functional assessments after 3 months.
Results: This study included 603 patients with the first time hemorrhagic stroke. Among these patients, 446 (74.0%) were classified as NCG, while 157 patients (26.0%) were belonged to the ICG at 3 month. Within the NCG, 372 patients (82.4%) were stable group, 26 patients (5.4%) were converter group, and 48 patients (12.2%) were reverter group at 12 months onset. Within the ICG group, 66 patients (53.0%) were stable group, 64 patients (36.1%) were converter group, and 27 patients (10.9%) were reverter group. When different factors were investigated, the three subgroups in NCG and ICG showed a few different factors affecting cognitive function from 3 to 12 month.
Conclusions: The prevalence of cognitive impairment showed little difference between 3 and 12 months after hemorrhagic stroke. By investigating the influencing factors from each group, the factors associated improvement or decline in cognitive function after hemorrhagic stroke were the age and sex factor in ICG of older patients, and the history of coronary heart disease and early GCS scores in ICG of total patients. |
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