• Title/Summary/Keyword: Stroke Disease Analysis

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The Comparison of Risk Factors for Ischemic Stroke or Intracranial Hemorrhage in Korean Stroke Patients: A Nationwide Population-based Study

  • Choi, Sun-Young;Kim, Ji-In;Hwang, Shin-Woo
    • Biomedical Science Letters
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    • v.24 no.4
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    • pp.405-410
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    • 2018
  • Stroke is a leading cause of death in the Korean population and remains a major health burden worldwide. The two main pathologic types of stroke are ischemic stroke and intracranial hemorrhage (ICH), but comparisons of risk factors for these have been limited. We under took a nationwide population-based study to analyze the relationship between these risk factor sand ischemic stroke and ICH. From January 2003 to December 2013, a total of 37,561 patients with newly diagnosed ischemic stroke or ICH were identified using the National Health Insurance Service data base as the study population. Multivariable logistic regression analysis was used to determine the association between baseline risk factors and presentation with ICH versus ischemic stroke. The incidence of ischemic stroke showed an increasing rend every year, while there was no significant change in the incidence of ICH. Of the several risk factors associated with stroke, old age (OR 2.35, 95% CI 2.12~2.49, P < 0.001) was more closely associated with ischemic stroke than ICH, whereas renal disease (OR 0.74, 95% CI 0.55~0.99, P = 0.04) and carotid disease (OR 0.25, 95% CI 0.17~0.35, P < 0.001) were more strongly associated with ICH. In addition, diabetes mellitus, dyslipidemia, hypertension, ischemic heart disease and male sex was associated with an increased risk of ischemic stroke. Old age was more strongly associated with ischemic stroke than ICH, while carotid stenosis and renal impairment were more closely associated with ICH risk. Classic risk factors for stroke have considerably different associations with the two main pathologic types of stroke.

Comparison Study on the Characteristics among Sasang Constitution in Acute Stroke Patients (급성기 중풍 환자의 사상체질에 따른 제특성 분포에 관한 임상적 연구)

  • Sun, Jong-Joo;Jung, Jae-Han;Choi, Chang-Min;Kim, Seok-Min;Kim, Chang-Hyun;Min, In-Gyu;Jeong, Dong-Won;Park, Sung-Uk;Jung, Woo-Sang;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup
    • The Journal of Internal Korean Medicine
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    • v.28 no.1
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    • pp.34-46
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    • 2007
  • Objectives: This study was to assess characteristics in acute stroke patients according to Sasangconstitution (SC). Methods : We assessed the type of SC of acute stroke patients in $2^{nd}$ Department of Internal Medicine at KyungHee University Oriental Hospital from October 2005 to September 2006. Each subject's SC type was confirmed when the result of QSCC II+ was in accordance with the opinion of the Sasangconstitutional medicine specialist. We investigated general characteristics, stroke type, blood test results, alcohol drinking, smoking and dietary preferences according to SC. Results: 108 subjects were included in the final analysis. This study showed that out of the total patients, the proportion of So-yang to Tae-eum to So-eum was equal to 5.5 to 3.5 to 1. Especially, men were higher proportion So-yang while women recorded a more significant ratio of Tae-eum. Also, the BMI, waist circumference, hip circumference, and WC/HC ratio recorded significantly high results. The result indicated that even though the Tae-eum let on the highest numerical value in the aspect of their past history and the final diagnosis, no significant difference was revealed according to SC. The ratio of cerebral infarction to cerebral hemorrhage was 9 to 1. SVO, LAA, SUE are the 3 types of cerebral infarction classified by TOAST; SVO ranked the highest while SUE ranked the lowest in all constitutions. The blood test result displayed that averages of both TL and the T-chol were the highest in Tae-eum while that of hematocrit in So-yangand that of HDL-chol in So-eum. However, there was no significant difference. There were no significant differences classified by gender or by SC in the aspect of the alcohol drinking and smoking history. The majority of So-yang and Tae-eum demonstrated a preference for meat while So-eum and So-yang displayed high preferences for sea food. Conclusions : With respect to these results. we could observe the general disposition of various characteristic distributions according to SC of acute stroke patients. For further research in this field. it seems necessary to construct fundamental databases for the prevention and treatment of stroke by increasing the number of patients observed and by analyzing delicate characteristics of each constitution type.

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An analysis of the causes of prehospital delays in patients with suspected acute stroke (급성 뇌졸중 의심 환자의 병원 전 지연 원인 분석)

  • Lee, Nam-Jin;Moon, Jun-Dong
    • The Korean Journal of Emergency Medical Services
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    • v.24 no.2
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    • pp.27-38
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    • 2020
  • Purpose: Stroke is a time-sensitive disease that could have reduced complications and mortality with timely diagnosis and treatment. This study aimed to analyze the causes of delay in detecting the clinical signs and symptoms of stroke. Methods: This retrospective observational study analyzed the emergency medical services reports of suspected stroke patients with positive predictive values on the Cincinnati Prehospital Stroke Scale. The study was conducted in Daejeon, Republic of Korea from January 1, 2016 through December 31, 2017. Results: Prolonged prehospital time was associated with high blood pressure, history of cerebrovascular disease, and incidences during daily activities, and sleep. High blood pressure and complications from a previous stroke strongly associated with the prolonged stroke-detection phase (p<.05). Total prehospital time was shortened when patients had evident stroke symptoms, such as decreased level of consciousness, dysarthria, and hemiplegia (p<.05). There was no significant difference in gender or age as a factor that delayed the total prehospital time of the suspected stroke patients. Conclusion: Many patients did not recognize the early clinical symptoms and signs of a stroke. Furthermore, risk factors, such as high blood pressure and history of stroke, prolonged the total prehospital time. Therefore, we need targeted interventions that educate about warning symptoms of stroke, along with emphasis on the importance of emergency calls to substantially reduce the prehospital delays.

A Comparison on the General Characteristics of Acute Stroke Patients between Fire-Heat and Deficiency of Yin (화열과 음허로 진단된 급성기 뇌질환 환자의 특성 비교 연구)

  • Kim, Hye-mi;Gwak, Ja-young;Cho, Seung-yeon;Shin, Ae-sook;Lee, In-whan;Kim, Na-hee;Na, Byung-Jo;Park, Seong-Uk;Jung, Woo-sang;Mun, Sang-gwan;Park, Jung-mi;Ko, Chang-nam;Cho, Ki-ho;Kim, Young-suk;Bae, Hyung-sup
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.10 no.1
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    • pp.33-39
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    • 2009
  • Objects : This study propose to compare on general characteristics of acute stroke patients between Fire-Heat group and Deficiency of Yin group. Method : We recruited acute stroke patient within 4 weeks after stroke admitted to Department of Internal Medicine of Kyunghee University Oriental Medicial Center, Dongguk University Ilsan Oriental Medical Center, Kyungwon University Songpa Oriental Medical Centar and Kyungwon University Incheon Oriental Medical Center from April 2007 to August 2009. We investigate age, sex, type of stroke, past history, general characteristics, smoking, drinking alcohol, marriage sasang constitution, etc. Result : It was significant different in sex, smoking, dringking alcohol and marriage between Fire-Heat group and Deficiency Yin group. We need more cases for another result that could associate with diagnosis of stroke. Conclusion : We found that Fire heat group was more associated with lifestyle than deficiency yin group. Further study will be needed to analysis for the diagnosis and the treatments of stroke.

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Weighting of Stroke Pattern Identification Using an AHP (AHP 기법을 이용한 중풍 변증지표의 가중치 설정)

  • Kang, Byoung-Kab;Kim, So-Yeon;Lee, Jung-Sup;Kim, No-Soo;Ko, Mi-Mi;Kwon, Se-Hyug;Bang, Ok-Sun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.25 no.1
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    • pp.149-153
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    • 2011
  • In this study, we structuralized the diagnostic indices used for pattern identification (PI) of stroke, and suggested an AHP method to obtain the weights of PI indices. AHP of the subjects under consistency ratio 0.1 showed that the critical indices for stroke PI consists of 9 for Qi-deficiency, 13 for Phlegm/dampness, 7 for blood stagnation, 12 for Yin-deficiency and 16 for Fire/heat. Furthermore, AHP analysis rendered the weights of indices of each PI that will be useful for oriental medical experts to perform objective PI.

Comparative Study of Stroke Treated by Acupuncture in the Medical Documents Of the Chosun-Korea Dynasty (조선(朝鮮) 의서(醫書)의 중풍(中風) 침구법(鍼灸法) 비교)

  • Oh, Jun-Ho;Cha, Wung-Seok;Kim, Nam-Il
    • Korean Journal of Oriental Medicine
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    • v.15 no.3
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    • pp.45-51
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    • 2009
  • Objectives : The objective of this article is to compare acupuncture treatment of stroke in the medical documents of the Chosun-Korea dynasty. Through such inquisition, the development process of acupuncture of stroke treatment could be found. Methods : We used Cross-comparison analysis of the contents of five medical books, HyangYakZipSungBang (HYZSB), UiRimChwarYo(URCY), DongEuiBoGam(DEBG), ChimGuGyungHumBang(CGGHB) and Saam-Acupuncture(SA) of the Chosun-Korea dynasty. Results & Conclusion : 1. Distinction between Stroke of Viscera and Stroke of Bowel was important. Firts two books divided stroke into three type. But last three books separated into Stroke of Viscera and Stroke of Bowel. 2. They emphasized Symptoms of Five Visceral Disease. They devised Symptoms of Five Visceral Disease for Stroke of Viscera treatment. This method appears very rarely in clinical medicine. 3. They used common important acupoint for treatment of stroke. Most of these acupoints exist at the limbs. 4. They chose acupoints on the opposite side against the symptom.

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Correlation Study between the Changes of the Fire- and Heat- Related Symptoms and Motor Function Recovery in Acute Cerebral Infarction Patients (급성기 뇌경색 환자의 화열증상 변화와 기능회복도간의 상관관계에 대한 연구)

  • Hyun, Sang-Ho;Min, Kyung-Dong;Yei, Young-Chul;Kang, Ah-Reum;Lee, Eun-Chan;Moon, Sang-Kwan;Cho, Ki-Ho;Jung, Woo-Sang;Park, Sung-Wook;Ko, Chang-Nam
    • The Journal of Internal Korean Medicine
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    • v.34 no.4
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    • pp.428-437
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    • 2013
  • Objectives : The aim of this study was to examine if there is a significant correlation between the changes of Fire- and Heat- related symptoms and motor function recovery in acute cerebral infarction patients. Methods : We studied inpatients within a month after the onset of cerebral infarction who were admitted at Kyunghee University Medical Center from May 2011 to January 2013. We executed correlation analysis between Fire-heat pattern score and motricity index score at visit 1 and visit 2, and checked if there was a significant correlation between the changes of Fire-heat pattern score and changes of motricity index score. Also, we compared the changes of both scores in patients taking Fire-heat and non Fire-heat pattern prescriptions. Results : There was a significant correlation between the Fire-heat pattern score and Motricity index score at visit 1 and visit 2, and changes of Fire-heat pattern score showed significant correlation with changes of motricity index score. Patients taking Fire-heat pattern prescriptions showed significant change in Fire-heat pattern score after herb-medication treatment while patients taking non-Fire-heat prescriptions showed insignificant change in Fire-heat pattern score. Conclusions : This study provides evidence that taking a Fire-heat pattern prescription could be considered as a first line herb-medication treatment in acute cerebral infarction patients.

Comparisons of Discriminant Analysis Model and Generalized Logit Model in Stroke Patten Identifications Classification (중풍변증분류에 사용되는 판별분석모형과 일반화로짓모형의 비교)

  • Kang, Byoung-Kab;Lee, Ju-Ah;Ko, Mi-Mi;Moon, Tae-Woong;Bang, Ok-Sun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.25 no.2
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    • pp.318-321
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    • 2011
  • In this study, when a physician make a diagnosis of the Pattern Identifications(PIs) of stroke patients, the development methods of the PIs classification function is considered by diagnostic questionnaire of the PIs for stroke patients. Clinical data collected from 1,502 stroke patients who was identically diagnosed for the PIs subtypes diagnosed by two clinical experts with more than 3 years experiences in 13 oriental medical hospitals. In order to develop the classification function into PIs using the 44 items-Fire&heat(19), Qi-deficiency(11), Yin-deficiency(7), Dampness phlegm(7)- of them was significant statistically by univariate analysis in 61 questionnaires totally, we make some comparisons of the results of discriminant analysis model and generalized logit model. The overall diagnostic accuracy rate of the PIs subtypes for discriminant model(74.37%) was higher than 3% of generalized logit model(70.09%).

The association of oral diseases and chronic diseases in Korean adult population (우리나라 성인의 구강질환과 만성질환의 관련성)

  • Cheon, Hye-Won;Yu, Mi-Sun;Choi, Mi-Hye
    • Journal of Korean society of Dental Hygiene
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    • v.12 no.2
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    • pp.235-249
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    • 2012
  • Objectives : The purpose of this research is to use data from the third year of the 4th National Health and Nutrition Examination Survey to study relationship between oral disease and chronic disease that generally persist from 6 months to over a year, or more specifically, circulatory disease, diabetes, and osteoporosis. Methods : Of the data from the third year of the 4th National Health and Nutrition Examination Survey, 7,893 adults over 19 years old who completed medical examination, health survey, and nutrition survey were selected as the final research subjects. Relationship between chronic disease and oral disease was analyzed by cross tabulation (2-test) and logistic regression analysis using SPSSWIN ver 18.0. Results : 1. Differences in the rate of prevalence of periodontal disease and the rate of prevalence of missing teeth were statistically significant with respect to age, gender, marital status, education level, residential area, income level, and occupation. Rate of prevalence of dental caries was statistically significant with respect to age, education level, and income level. 2. After examining the relationship between existence of chronic disease as diagnosed by doctor with oral disease, rate of prevalence of periodontal disease and missing teeth, hypertension, hyperlipidemia, stroke, myocardial infarction, angina, diabetes, and osteoporosis showed statiscally significant difference. 3. Examination of rate of prevalence of chronic disease with respect to oral disease, periodontal disease and missing teeth exerted statistically significant influence on hypertension, hyperlipidemia, stroke, myocardial infarction, angina, diabetes, and osteoporosis (p<0.05), while dental caries did not have statistically significant effect. 4. Analysis of coupling effect of periodontal disease and missing teeth on chronic disease showed that they were related in all chronic diseases examined in this study (hypertension, hyperlipidemia, stroke, myocardial infarction, angina, diabetes, and osteoporosis) (p<0.05). Conclusions : Periodontal disease and missing teeth were found to increase the rate of prevalence of chronic disease.

Propensity score matching analysis on inpatient period differences of hemorrhagic stroke survivors depending on medical insurance coverage

  • Kim, Sang-Mi;Kim, Young;Lee, Seong-A
    • Physical Therapy Rehabilitation Science
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    • v.8 no.2
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    • pp.67-73
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    • 2019
  • Objective: The purpose of this study was to compare the differences in the length of hospital stay between hemorrhage stroke survivors with health insurance and those with medical care after controlling all factors except for the type of medical insurance by using the propensity score matching (PSM) method. Design: Retrospective cohort study. Methods: Data from the Korean National Centers for Disease Control and Prevention's In-Depth Discharge Injury Survey between the years 2006 and 2012 were used for analysis. A total of 4,538 cases were defined as persons with hemorrhagic stroke (I60-I62) based on the block of categories in the International Classification of Diseases (10th). In order to analyze the inpatient period differences depending on the type of health care, which reflects one's socio-economic level, the chi-square and t-test was conducted. Results: Frequency and percentage were presented, and regression analysis was used to determine the factors affecting the inpatient period. Age, severity of disease, treatment outcome, and post-discharge status were no longer statistically significant after matching. The inpatient period of the persons receiving medical aid benefits was found to be significantly longer than those with national health insurance (p<0.05). Conclusions: The factors influencing the inpatient period of hemorrhagic stroke survivors were treatment outcomes, severity of disease, hospital admission process, and the type of health care. It is necessary for systematic and comprehensive governmental management for persons with hemorrhagic stroke to be transferred to long-term care facilities.