Background and Purpose: The hospital-based stroke registry is a well-establ
ished method useful for understanding diverse clinical characteristics of s
troke related to geographical, racial or environmental differences. We anal
yzed the data from 1,000 patients with acute cerebral infarctions registere
d with the Yonsei Stroke Registry (YSR) which is the first prospective hosp
ital-based observational study in Korea. Methods: All patients had cerebral
infarctions and presented within 7 days of onset. CT or MRI was performed
in all patients and a vascular imaging study (digital subtraction or magnet
ic resonance angiography) was conducted in 53.9% of the patients. Subtype c
lassification was made through a consensus approach based on the strict app
lication of TOAST criteria. Results: The mean age of patients was 62 +/- 12
years, and 60.8% were males. Undetermined cause (UD) was the most frequent
subtype (40.6%), which was followed by lacunar stroke (LS 21.5%), cardiac
embolism (CE 18.3%), large-artery atherosclerosis (LAA 16.5%) and other det
ermined causes (3.1%). Hypertension was found in 64.3%, smoking in 35.2%, d
iabetes mellitus in 26.9%, hypercholesterolemia in 24.1%, high hematocrit (
greater than or equal to 50%) in 21.8%, clinically identified potential car
diac sources of embolism in 18.3%, a history of previous stroke in 22.0% an
d a history of previous transient ischemic attack in 4.7%. Recurrent stroke
was associated with a higher number of risk factors (p < 0.001) and a high
er incidence of LAA (p = 0.003) than the first stroke. Vertebrobasilar arte
ry territorial infarction was found in 39.8%, which was associated with hig
her incidences of LAA and LS and a lower incidence of CE than carotid arter
y territorial lesions (p = 0.001). The 30-day mortality rate was 5.3% and c
erebral herniation caused early death in 52%. Conclusion: The distribution
of stroke subtypes in the YSR was largely comparable with that of western r
egistries. The highest incidence of UD might be related to the strict appli
cation of TOAST criteria. Copyright (C) 2001 S. KargerAG, Basel.