BACKGROUND To determine the functional outcomes in each period for adult ischemic and hemorrhagic Moyamoya disease (MMD) patients and identify prognostic factors. METHODS The current retrospective study reviewed consecutive adult MMD patients surgically treated from January 2012 to June 2017. Perioperative clinical data were collected and follow-up was conducted via telephone interviews. Functional outcomes and prognostic factors were analyzed. RESULTS A total of 219 ischemic MMD patients (268 hemispheres) and 157 hemorrhagic patients (193 hemispheres) were included. The median follow-up time was 18 months (3-69 months). MMD type had no significant effect on the modified Rankin Scale(mRS) score at discharge. Perioperative complications (P = 0.004) and the mRS score at baseline (P < 0.001) were risk factors correlated with the short-term functional outcomes in both groups, while diabetes mellitus (DM, P = 0.022) also played a role in the ischemic group. During the follow-up period, functional outcomes obviously improved in both groups, but two groups showed nonproportional cumulative curves for favorable functional outcomes (log-rank test, P = 0.483). Stroke recurrence (P < 0.001) and mRS at discharge (P < 0.001) were common factors related with long-term functional outcomes in two types of MMD patients. Particularly, female patients with ischemic MMD were more likely to have higher mRS scores (P = 0.028) and Suzuki stage was positively associated with long-term functional outcomes in hemorrhagic group (P = 0.044). CONCLUSIONS MMD type had no significant effect on prognosis while both types of MMD patients showed overall significant improvements in functional outcomes after surgery. Different types of MMD patients have distinct prognostic factors for short-term and long-term functional outcomes.

中文翻译：

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两种成人烟雾病的术后功能结果和预后因素。

背景技术为确定成人缺血性和出血性烟雾病（MMD）患者在每个时期的功能结局，并确定预后因素。方法本回顾性研究回顾了2012年1月至2017年6月连续接受手术治疗的成年MMD患者。围手术期收集临床数据，并通过电话访谈进行随访。分析了功能结局和预后因素。结果总共包括219名缺血性MMD患者（268个半球）和157名出血性患者（193个半球）。中位随访时间为18个月（3-69个月）。MMD类型对出院时改良的Rankin量表（mRS）评分无明显影响。围手术期并发症（P = 0.004）和基线时的mRS评分（P <0。001）是两组短期功能结局相关的危险因素，而糖尿病（DM，P = 0.022）在缺血组中也起作用。在随访期间，两组的功能结局均明显改善，但两组显示出不成比例的累积曲线，以取得良好的功能结局（log-rank检验，P = 0.483）。在两种类型的MMD患者中，卒中复发（P <0.001）和出院mRS（P <0.001）是与长期功能预后相关的常见因素。尤其是，患有缺血性MMD的女性患者更有可能获得更高的mRS评分（P = 0.028），出血组的Suzuki分期与长期功能预后正相关（P = 0.044）。结论MMD类型对预后没有显着影响，而两种类型的MMD患者术后均显示出整体功能改善。不同类型的MMD患者对于短期和长期功能结局具有不同的预后因素。