Outcome and Prognostic Factors for Patients with Malignant Middle Cerebral Artery Infarction

• Main Authors: Wing-Him Lau, 劉穎謙
• Other Authors: 周希諴
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/13769731876705965272

碩士 === 中山醫學大學 === 醫學研究所 === 102 === Background: The patients with malignant middle cerebral artery (MCA) infarction often have a poor prognosis and a high hazard ratio of death. Early interventions can enhance treatment effects on MCA patients and then increase their survival rate and quality of life. Objectives: A retrospective cohort method was introduced into this study. We performed one-year outcome and survival analysis for MCA patients. From 2008 to 2012, the qualified MCA patients were enrolled in this study from a regional hospital of middle Taiwan region. The main indicator of outcome is death. We perform the Kaplan-Meier test and the Cox-regression to evaluate the hazard ratio of death for patients with malignant middle cerebral artery. The duration of follow-up is one year. A significant level of α-value is set at 0.05. Results: In all, there are ninety-five MCA patients in this survey and their one-year survival rate is 64.2%. According to the results by Cox-regression, the significant risk factors of death for these patients include bilateral infarction (p<0.05) and midline shift of the brain more than 10 mm (p<0.05). Decompressive hemicraniectomy, comorbidity, and bad habits present a non-significant correlation. Conclusion: The MCA patients are in high risk of death. Decompressive craniectomy is an alternative surgical therapy, but its clinical benefit should be assessed carefully.