2026-06-11 国立循環器病研究センター
◆研究では日韓の高度専門医療機関に入院した脳梗塞患者9,868人を解析し、16.7％に退院時失語が認められた。年齢、基礎疾患、脳卒中重症度、退院時の身体機能、自宅退院か転院かといった要因を調整後も、失語を有する患者は3か月後の機能悪化リスクが高く、日本では死亡リスクとも有意に関連していた。特に重症の全失語では、日韓両国で機能予後不良や死亡の危険性が顕著だった。失語は会話や読解、書字能力を障害するが、外見からは分かりにくいため見過ごされやすい。
◆本研究は、失語そのものが脳卒中後の予後を左右する重要因子であることを示し、早期評価や専門的リハビリテーション、コミュニケーション支援技術の充実が機能維持や生命予後改善に重要であることを示唆した。
＜関連情報＞
脳卒中後失語症の予後への影響：三次医療機関における多施設共同コホート研究 Prognostic Implications of Poststroke Aphasia: A Multicenter Cohort Study in Tertiary Hospitals
Tomotaka Tanaka, MD, PhD, Kwanju Song, MD, Satoshi Saito, MD, PhD, Sonu Bhaskar, MD, PhD, Soichiro Abe, MD, Hiroyuki Ishiyama, MD, PhD, Kazuki Fukuma, MD, PhD, … , and Masafumi Ihara, MD, PhD
Journal of the American Heart Association Published:9 June 2026
DOI:https://doi.org/10.1161/JAHA.125.047996
Abstract
Background
Poststroke aphasia (PSA) may adversely affect recovery after ischemic stroke, but its association with functional decline and death remains unclear. We investigated the prognostic impact of PSA in survivors of stroke.
Methods
This international observational cohort study included patients admitted to tertiary hospitals in Japan and South Korea within 7 days of ischemic stroke between 2011 and 2023. PSA was assessed using the language subscore of the National Institutes of Health Stroke Scale at discharge. Outcomes were worsening of the modified Rankin Scale score by ≥1 point and all‐cause death at 3 months in both cohorts and at 1 year in the Japanese cohort, using discharge as the index time point. Associations between PSA severity and outcomes were examined using multivariable models.
Results
Among 9868 patients, 1651 (16.7%) had PSA, which independently predicted 3‐month worsening modified Rankin Scale score in Japan (odds ratio [OR], 2.52 [95% CI, 2.08–3.04]) and South Korea (OR, 1.68 [95% CI, 1.31–2.15]). PSA was associated with 3‐month death in Japan (OR, 3.47 [95% CI, 2.38–5.07]), while only global PSA predicted 3‐month death in South Korea (OR, 2.11 [95% CI, 1.28–3.47]). In Japan, PSA remained associated with 1‐year worsening modified Rankin Scale score (OR, 1.84 [95% CI, 1.49–2.26]) and death (OR, 2.63 [95% CI, 2.03–3.40]).
Conclusions
PSA is independently associated with functional decline and death after ischemic stroke. Early recognition and targeted management of PSA may improve poststroke outcomes.
