DOI: https://doi.org/10.30841/2307-5112.1-2.2020.204543

Causes of Mortality in Patients with Chronic Cerebral Ischemia in Multifocal Atherosclerosis

О. А. Росицька

Abstract


The objective: to evaluate the causes of death in patients with chronic brain ischemia with multifocal atherosclerosis.

Materials and methods. The study included 137 patients aged 40 to 84 years with chronic brain ischemia (CBI) against the background of multifocal atherosclerosis, which were divided into three clinical groups depending on the localization of vascular pool affection by stenosic atherosclerosis. The causes of death for 10 years were analyzed.

Results. In the general group of investigated causes of death comorbid pathology (myocardial infarction, CHD with hypertensive disease) prevailed – 66,7 % of cases (30 among 45 dead) at p<0,01. Strokes of various types amounted to 20.0 % of cases (9 among 45 dead) and polymorbid pathology – 13.3 % (6 among 45 dead). The age of those who died between 50 and 60 years was 8.9 %, between 60 and 70 years old – 22.2 % and over 70 years old – 68.9 % of cases. Among the causes of death in all clinical groups, comorbid pathology significantly prevailed over stroke: in the first group – in 16.7% and 3.3% respectively, in the second group – in 24.1 % and 5.7 % respectively, and in the third group – in 20.0 % of cases of comorbid pathology without strokes. Mortality rate in chronic course of the disease was 47.8 %, in CBI with TIA – 13.4 %, in CBI with another stroke in the history – 30.5%, in CBI with repeated strokes in the history – 35.0 %. Strokes among the causes of death were more often established in the group of patients with CBI with recurrent strokes.

Conclusions. Comorbid pathology as a modifiable factor, irrespective of the combination of vascular pools affected by atherosclerosis and the nature of the CBI flow, prevailed among the causes of death in patients with CBI in the background of multifocal atherosclerosis. Strokes of various types were the second leading cause of death in patients with CBI. In the analysis of mortality among patients with different types of CBI course was established reliably high its frequency in the group of persons with chronic course of disease without acute episodes of ischemia in the history with high rate of mortality from comorbid pathology.

Keywords


chronic brain ischemia; mortality; comorbidity; polymorbidity; risk factors

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ISSN (print): 2307-5112.