Document Detail

Neck circumference, a bedside clinical feature related to mortality of acute ischemic stroke.
MedLine Citation:
PMID:  22012291     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The aim of this study was to evaluate clinical/demographic factors, sleep alterations and one year mortality in acute ischemic stroke.
METHODS: This was a prospective study of 89 consecutive patients (mean age 64.39 ± 8.51 years) with acute ischemic stroke. High risk of obstructive sleep apnea (OSA) was evaluated by the Berlin questionnaire, daytime somnolence by the Epworth Sleepiness Scale (> 10) and subjective sleep quality by the Pittsburgh Sleep Quality Index (> 5). Clinical and anthropometric data including body mass index, hip-waist ratio, neck circumference (NC) were obtained. Increased NC was defined if > 43 cm in men and > 38 cm in women. Stroke severity was estimated by the Barthel Index and the modified Rankin Scale. The end-point was death after 12 months follow-up.
RESULT: One-year mortality was 8.9%. Non-survivors were older (p = 0.006) and had larger NC (p = 0.02). Among all cases, large NC was related to high risk of OSA, diabetes and hypertension (Fisher's exact test). Compared to men, women showed relatively larger NC. Overall, family history of stroke (74.2 %), diabetes (33.7%) and hypertension (78.6%) were frequent; obesity (11.2%) was uncommon. Daytime sleepiness (34.8 %), poor sleep quality (65.2%) and risk of OSA (58.42%) were frequently found.
CONCLUSION: Poor sleep quality, excessive daytime sleepiness and high risk of OSA are frequent in this sample with acute ischemic stroke. One-year mortality was related to older age and large NC. As obesity is uncommon in acute stroke patients, a large NC should be taken as a significant clinical sign related to mortality.
Camila Andrade Mendes Medeiros; Veralice Meireles Sales de Bruin; Claudia de Castro-Silva; Sonia Maria Holanda Almeida Araújo; Cauby Maia Chaves Junior; Pedro Felipe Carvalhedo de Bruin
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Revista da Associação Médica Brasileira (1992)     Volume:  57     ISSN:  0104-4230     ISO Abbreviation:  Rev Assoc Med Bras     Publication Date:    2011 Sep-Oct
Date Detail:
Created Date:  2011-10-20     Completed Date:  2012-03-07     Revised Date:  2012-04-11    
Medline Journal Info:
Nlm Unique ID:  9308586     Medline TA:  Rev Assoc Med Bras     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  559-64     Citation Subset:  IM    
Universidade Federal do Ceará, Fortaleza, CE, Brazil.
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MeSH Terms
Aged, 80 and over
Body Mass Index
Disorders of Excessive Somnolence / complications*
Middle Aged
Neck / anatomy & histology*
Prospective Studies
Risk Factors
Severity of Illness Index
Sleep Apnea, Obstructive / complications*
Stroke / etiology,  mortality*

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