Yonsei Stroke Registry - Analysis of 1,000 patients with acute cerebral infarctions

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.