• 作者：P. Sobrino Garc¨ªa ; A. Garc¨ªa Pastor ; A. Garc¨ªa Arratibel ; G. Vicente Peracho ; P.M. Rodriguez Cruz ; J.R. P¨¦rez S¨¢nchez ; F. D¨ªaz Otero ; P. V¨¢zquez Al¨¦n ; J.A. Villanueva Osorio ; A. Gil N¨²?ez
• 关键词：Clasificació ; n etioló ; gica ; Clasificació ; n A-S-C-O ; Clasificació ; n del Grupo de Estudio de Enfermedades Cerebrovasculares de la Sociedad Españ ; ola de Neurologí ; a ; Ictus de causa indeterminada
• 刊名：Neurologa
• 出版年：2013
• 出版时间：September, 2013
• 年：2013
• 卷：28
• 期：7
• 页码：417-424
• 全文大小：303 K

Introduction

The A-S-C-O classification may be better than other methods for classifying ischaemic stroke by aetiology. Our aims are to describe A-S-C-O phenotype distribution (A: atherosclerosis, S: small vessel disease, C: cardiac source, O: other causes; 1: potential cause, 2: causality uncertain, 3: unlikely to be a direct cause although disease is present) and compare them to the Spanish Society of Neurology¡®s Cerebrovascular Disease Study Group (GEECV/SEN) classification. We will also find the degree of concordance between these classification methods and determine whether using the A-S-C-O classification delivers a smaller percentage of strokes of undetermined cause.

Methods

We analysed those patients with ischaemic stroke admitted to our stroke unit in 2010 with strokes that were classified according to GEECV/SEN and A-S-C-O criteria.

Results

The study included 496 patients. The percentages of strokes caused by atherosclerosis and small vessel disease according to GEECV/SEN criteria were higher than the percentages for potential atherosclerotic stroke (A1) (14.1 vs. 11.9 % ; P=.16) and potential small vessel stroke (S1) (14.3 vs. 3 % ; P<.001). Cardioembolic stroke (C1) was more frequent (22.2 vs. 31 % ; P<.001). No differences between unusual cause of stroke and other potential causes (O1) were observed. Some degree of atherosclerosis was present in 53.5 % of patients (A1, A2, or A3); 65.5 % showed markers of small vessel disease (S1, S2, or S3), and 74.9 % showed signs of cardioembolism (C1, C2, or C3). Fewer patients in the group without scores of 1 or 2 for any of the A-S-C-O phenotypes were identified as having a stroke of undetermined cause (46.6 vs. 29.2 % ; P<.001).

The agreement between the 2 classifications ranged from ¦Ê<0.2 (small vessel and S1) to ¦Ê>0.8 (unusual causes and O1).

Conclusion

Our results show that GEECV/SEN and A-S-C-O classifications are neither fully comparable nor consistent. Using the A-S-C-O classification provided additional information on co-morbidities and delivered a smaller percentage of strokes classified as having an undetermined cause.