Özet:
Introduction: Few studies have reported the predictive factors related to
mortality in patients with cranio-cervical artery dissections (CCAD). Our
aim was to investigate the predictors related to in-hospital mortality in
patients with CCAD and its subgroups.
Methods: Sixty-seven patients diagnosed with carotid artery dissection
(CAD) or vertebral artery dissection (VAD), admitted to our clinic
between 2000 and 2013, were retrospectively reviewed. Age,
gender, modified Rankin Scale scores (pre-stroke and at admission),
clinical presentation type, location of the dissection, risk factors, and
treatments were analyzed as mortality-related prognostic factors. Of
the 67 patients, 12 (17.9%) died, five (7.46%) with CAD and seven
(10.44%) with VAD. We compared the prognostic characteristics of the
surviving versus deceased patients with CCAD and in the subgroups
with CAD and VAD.
Results: Age above 45 years, severe disability at admission, presentation
with stroke, and intracranial VAD occurred more frequently in deceased
patients and were independent variables related to mortality in patients
with CCAD and its subgroup with VAD. Severe disability at admission
alone was related to mortality in patients with CAD. Hypertension and
hypercholesterolemia were independent variables related to mortality in
patients with CCAD.
Conclusion: Severe disability at admission was a mortality predictor in
both CAD and VAD. Although the initial severity of stroke is reportedly
related to poor outcomes in patients with CCAD, it has not previously
been directly identified as a predictor of mortality in patients with CAD
or VAD.