Abstract
Objective : This study investigated the prevalence of and risk factors associated with cerebral infarction subtypes, and their association with the interval until hospitalization at Juntendo University Hospital.
Patients and Methods : We examined hospitalization records of 362 cerebral infarction patients aged 65 years or older who had been treated between January 1, 2003 and December 31, 2005, and analyzed the association of thrombotic (lacunar and atherothrombotic cerebral infarction) and embolic (cardioembolic infarction) cerebral infarction with the risk factors for arteriosclerosis that comprise metabolic syndrome. We next examined the association between the number of days between onset and hospitalization due to thrombotic and embolic cerebral infarction by classifying cases into 2 periods : less than 48 hours or 2-7 days. We also examined the association between the number of days from onset to hospitalization with age and gender.
Results : While a history of hypertension was significantly associated with thrombotic cerebral infarction when comparing cerebral infarction subtypes (embolic and thrombotic) and risk factors for arteriosclerosis, other risk factors for arteriosclerosis were not associated with cerebral infarction subtype. There was no association between cerebral infarction subtype and number of days between onset and hospitalization stratified by risk factors for arteriosclerosis. A significant difference was found for hospitalization within less than 48 hours between thrombotic (177/238, 74.4 %) and embolic (52/55, 94.5 %) subtypes; patients with the latter subtype were hospitalized earlier. A significant difference was also seen between both genders and all ages when the number of days from onset to hospitalization was compared.
Discussion : Potential reasons for the low association between cerebral infarction with risk factors that comprise metabolic syndrome versus the significant association with hypertension include : a large number of cases with cerebral infarction involving a penetrating artery, considerable differences in epidemiological research design (this was a cross-sectional, rather than a longitudinal study), and the use of a study population from a university hospital (severe cases are more common in this population compared to the incidence at a general hospitals). We found that embolic cerebral infarction patients underwent earlier hospitalization compared to thrombotic cerebral infarction patients, likely because onset of cerebral embolism can be clearly diagnosed at an early stage due to the rapid development of symptoms.
