復發性腦梗塞之危險因子與預後分析

Analysis of Prognosis and Risk Factors of Recurrent Ischemic Stroke

侯欣妤(Hsin-Yu Hou) ； 洪啟偉(Chi-Wei Hung) ； 葉昭宏(Chao-Hung Yeh) ； 黃建程(Chien-Cheng Huang) ； 蘇世斌(Shih-Bin Su) ； 陳思豪(Sih-Hao Chen)

《台灣家庭醫學雜誌》 23卷2期 (2013/06) Pp. 69-82

摘要

Background: Sequelae and physical disabilities associated with recurrent strokes are often more severe and exhibit higher mortality than initial occurrences. Therefore, we aim to analyze the risk factors and prognosis associated with recurrent ischemic stroke.Methods: This retrospective study collected data from patients who suffered from stroke and had complete records from January 1, 2009 to December 31, 2010. We used the National Institute of Health Stroke Scale (NIHSS) and the Barthel Index (BI) to assess stroke prognosis. Recurrent cerebral infarction risk factors were investigated with univariate and multiple logical regression analysis.Results: In total, 2,175 patients were included in our study, including 552 (25%) with recurrent cerebral infarctions. Most recurrent infarctions occurred in patients ＞65 years of age (~67%). Patients with hypertension, history of smoking, heart disease, recent infection, and uremia had higher risks of recurrent stroke. Higher NIHSS scores were present in those either hospitalized or discharged who had history of cerebral infarction. There were a higher proportion with the Barthel Index classified into complete dependence (BI ≤ 20) and severe dependence (21 ＜ BI ≤ 60). Multiple logistic regression analysis showed hypertension, smoking, history of heart disease, recent infection, and uremia were independent risk factors for recurrent cerebral infarctions. Alcohol consumption was also a protective factor.Conclusion: The study found that hypertension, smoking, history of heart disease, recent infection, and uremia increased the risk of recurrent stroke. Reducing risk factors and managing these chronic diseases were the most effective stroke prevention strategies.

並列摘要

Background: Sequelae and physical disabilities associated with recurrent strokes are often more severe and exhibit higher mortality than initial occurrences. Therefore, we aim to analyze the risk factors and prognosis associated with recurrent ischemic stroke.Methods: This retrospective study collected data from patients who suffered from stroke and had complete records from January 1, 2009 to December 31, 2010. We used the National Institute of Health Stroke Scale (NIHSS) and the Barthel Index (BI) to assess stroke prognosis. Recurrent cerebral infarction risk factors were investigated with univariate and multiple logical regression analysis.Results: In total, 2,175 patients were included in our study, including 552 (25%) with recurrent cerebral infarctions. Most recurrent infarctions occurred in patients ＞65 years of age (~67%). Patients with hypertension, history of smoking, heart disease, recent infection, and uremia had higher risks of recurrent stroke. Higher NIHSS scores were present in those either hospitalized or discharged who had history of cerebral infarction. There were a higher proportion with the Barthel Index classified into complete dependence (BI ≤ 20) and severe dependence (21 ＜ BI ≤ 60). Multiple logistic regression analysis showed hypertension, smoking, history of heart disease, recent infection, and uremia were independent risk factors for recurrent cerebral infarctions. Alcohol consumption was also a protective factor.Conclusion: The study found that hypertension, smoking, history of heart disease, recent infection, and uremia increased the risk of recurrent stroke. Reducing risk factors and managing these chronic diseases were the most effective stroke prevention strategies.

並列關鍵字

cerebral infarction ； stroke ； risk factor ； recurrent stroke ； secondary prevention

參考文獻

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