The main factors affecting the long-term outcomes in patients after acute cerebrovascular disorder: results of the LIS-2 study

Martsevich, S. Yu.; Кутишенко, Н. П.; Суворов, А. В.; Zagrebelnyy, A. V.; Гинзбург, М. Л.; Деев, А. Д.

doi:10.20996/1819-6446-2016-12-1-51-55

Cited by 4 publications

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References 8 publications

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“…Российский регистр МИ ЛИС-2 (Люберецкое исследование смертности больных, перенесших мозговой инсульт) включал больных, у которых МИ произошел в 2009-2011 гг. В уже опубликованных данных по отдаленному наблюдению медиана наблюдения за больными, с которыми удалось установить повторный контакт, составила 2,8 (2,1; 3,5) года [9,10]. Недавно была получена и проанализирована информация о более длительном наблюдении за этими пациентами: медиана наблюдения составила 6,9 (6,1; 7,7) лет.…”

Section: регистр острого нарушения мозгового кровообращения лис-2: ноunclassified

Registry of Acute Cerebral Circulatory Disorders Lis-2: New Data on Long-Term Follow-Up

Martsevich

Кутишенко

Zagrebelnyy

et al. 2018

Racionalʹnaâ farmakoterapiâ v kardiologii

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Результаты. В конце наблюдения оставались в живых 300 больных, умерли 543 человека, жизненный статус 117 больных оставался неизвестен. Кривая Каплана-Мейера показала, что смертность была наиболее высокой в первый год после МИ, затем она cстабилизировалась и оставалась практически неизменной до окончания периода наблюдения. Примерно через 8 лет наблюдения в живых осталось менее трети больных. Выявление причин смерти было в значительном числе случаев затруднено (в 52% случаев уточнить причину не удалось). МИ и другие цереброваскулярные заболевания, как причина смерти отмечены у 15% умерших, другие сердечно-сосудистые заболевания-у 18%, онкология-у 7%, травмы-у 4%. Такие причины смерти как острый инфаркт миокарда, заболевания легких или легочная эмболия составили в структуре смерти только по 2%. Отмечена тенденция к снижению доли повторного МИ как причины смерти по мере увеличения сроков наблюдения. Заключение. Смертность больных, перенесших МИ, на протяжении всего срока наблюдения остается стабильно высокой: через 8 лет в живых осталось менее трети больных. В структуре основных причин смерти на отдаленном этапе наблюдения была смерть от МИ и сердечнососудистых заболеваний. Необходим анализ факторов, определяющих неблагоприятный исход в различные сроки после МИ.

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Section: регистр острого нарушения мозгового кровообращения лис-2: ноunclassified

Registry of Acute Cerebral Circulatory Disorders Lis-2: New Data on Long-Term Follow-Up

Martsevich

Кутишенко

Zagrebelnyy

et al. 2018

Racionalʹnaâ farmakoterapiâ v kardiologii

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“…Риск смерти у больных инсультом, связанным с ФП, в 2 раза выше, а затраты на лечение возрастают в 1,5 раза [1]. Наличие ФП у пациентов с острым нарушением мозгового кровообращения является значимым фактором, определяющим неблагоприятный исход [4]. Доказано, что благоприятное влияние на прогноз у больных с ФП оказывает терапия оральными антикоагулянтами (ОАК).…”

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Comparative Analysis of Factors Affecting the Prognosis of Patients with Atrial Fibrillation According to the Results of the REKUR-AF Study

Polshakova

Поветкин

2019

Racionalʹnaâ farmakoterapiâ v kardiologii

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Aim. To conduct a comparative analysis of the significance of the influence of various factors and their combinations on the survival of patients with atrial fibrillation (AF) in the REKUR-AF study.Material and methods. The database includes 896 patients with AF over 18 years old who applied to medical organizations in the city of Kursk and seven districts of the Kursk region from September 2015 to August 2016. Achievement by the patients of the “end point” (death from any cause) was assessed using a telephone contact for a period of 9.0±0.55 months from the end of the database formation. Data were obtained on 532 patients, of which 60 patients reached the end point. To study the differences in survival in subgroups of patients with different characteristics, two groups of categorized factors were analyzed – clinical (sex, age, form of AF, etc.) and pharmacological (use of different classes of drugs). The necessary information was obtained from outpatient cards analyzed when patients were included in the study.Results. The survival rate of patients with AF was significantly (p<0.05-0.001) influenced by the following factors and their categories: age (<60 years – 92.5%, 60-65 years – 92.9%, over 75 years – 80.1%); AF form (paroxysmal – 95.1%, persistent – 93.2%, permanent – 84.4%); stable angina (SA) (presence – 86.5%, absence – 90.7%); chronic heart failure functional class (CHF FC) (I-II – 95.9%, III – 91.5%, IV – 69.6%); glomerular filtration rate (GFR) (>50 ml/min – 89.6%, 30-50 ml/min – 85.8%, <30 ml/min – 72.7%); diabetes mellitus (DM) (presence – 81.9%, absence – 90.4%), hospitalization for the year preceding inclusion in the study (presence – 85.5%, absence – 97.3%), the use of oral anticoagulants (OAC) (presence – 96.7%, absence – 87.1%). In subgroups of patients with the above mentioned categories (especially the most severe) of the studied factors, significant (p<0.05-0.01) differences in the proportion of surviving patients depending on the appointment of OAC were revealed: age >75 years – 78.2% and 100%; permanent form of AF – 81.9% and 96.1%, the presence of SA – 85.0% and 94.7%; CHF FC IV – 67.0% and 91.7%; GFR<30 ml/min – 62.5% and 100%; presence of DM – 80.7% and 88.2%.%; the presence of hospitalizations in the last year – 82.9% and 97.2%; >5 points on the CHA2DS2VASc scale – 67.0% and 91.7%, heart rate >90/min – 68.8% and 100% of patients with the absence and presence of the OAC therapy, respectively. Cox regression analy sis revealed clinical predictors contributing to an increase in the risk of death: age over 75 years, permanent form of AF, CHF FC III-IV, the presence of DM, the presence of previous hospitalizations. The absence of the OAC taking was accompanied by an increase in the risk of death by 3.66 times.Conclusion. The results of the REKUR-AF study allowed to establish the most significant factors affecting the survival of patients with AF: age, form of AF, CHF FC, presence of DM, hospitalization in the last year preceding the inclusion of patients in the study, OAK taking. The prescription of OAC is a priority predictor that improves survival in patients with AF.

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A regional experience of the optimization of neurological care for the rural population

Lebedeva

Брынза

Kulikova

et al. 2017

Z. nevrol. psikhiatr. im. S.S. Korsakova

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At present, the problem of disparity of healthcare, including neurological care, in urban and rural settings is highly relevant. Medical care after acute stroke or other chronic disabling diseases (epilepsy, Parkinson's disease) in rural settings is quite challenging due to the lack of access to specialized medical treatment facilities, low level of resources in medical and obstetric centers, low quality of healthcare, personnel turnover in rural healthcare and insufficient coverage of population with outpatient follow-up services. The most promising optimization approaches, which proved to be effective both abroad and in the Russian Federation, including Tyumen district, are the development of multidisciplinary mobile teams and telemedicine. Introduction of these approaches provides an increased access of rural population to specialized medical care, which leads to improvement in overall population health status.

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The main factors affecting the long-term outcomes in patients after acute cerebrovascular disorder: results of the LIS-2 study

Cited by 4 publications

References 8 publications

Registry of Acute Cerebral Circulatory Disorders Lis-2: New Data on Long-Term Follow-Up

Registry of Acute Cerebral Circulatory Disorders Lis-2: New Data on Long-Term Follow-Up

Comparative Analysis of Factors Affecting the Prognosis of Patients with Atrial Fibrillation According to the Results of the REKUR-AF Study

A regional experience of the optimization of neurological care for the rural population

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