Open AccessAnalysis of Prognostic Risk Factors for Ischemic Stroke in China: A Multicentre Retrospective Clinical Study; A National Survey in China
Author(s) -
Yuting Cao,
Ying Chen,
Xiaoli Li,
Yongjun Wang
Publication year - 2022
Publication title -
current neurovascular research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.592
H-Index - 54
eISSN - 1875-5739
pISSN - 1567-2026
DOI - 10.2174/1567202619666220331160024
Subject(s) - medicine , stroke (engine) , diabetes mellitus , atrial fibrillation , hazard ratio , odds ratio , univariate analysis , physical therapy , confidence interval , multivariate analysis , mechanical engineering , engineering , endocrinology
Background: Stroke is a serious disease that threatens human health both in China and worldwide. Identifying and establishing its risk factors are prerequisites for intervention and the evaluation of prognosis. Over the years, risk factors such as age, diabetes and hypertension have gradually been established. However, at present, there is no consensus on the influence of sex on the prognosis of ischaemic stroke.The aim of our research was to analyse the correlation between sex and poststroke prognosis based on the results of the Third China National Stroke Registry [CNSR-III], as well as the influence of other risk factors that may be confounded by sex on ischaemic stroke and potential interventions. Methods: The CNSR-III recruited 14146 acute ischaemic stroke [AIS] patients between 2015 and 2018. Our study included 13,972 patients who had complete follow-up information. This research analysed basic information, socioeconomic status, lifestyle habits, medical history and poststroke prognosis. Results: There was a conspicuous relationship between sex and functional prognosis, stroke recurrence and all-cause death due to ischaemic stroke in univariate analysis. Male stroke patients had a better prognosis than female patients. In multivariate analysis, we found that age, atrial fibrillation [AF], diabetes, hypertension and the severity of stroke had adverse effects on ischaemic stroke prognosis. After adjustment for other risk factors, the functional prognosis of female patients at 3 months was worse than that of male patients [odds ratio [OR]: 1.16, 95% confidence interval [CI], 1.025-1.314]. Sex had a nonsignificant association with stroke recurrence at 3 months [hazard ratio [HR]: 1.141, 95% CI, 0.975-1.336]. Furthermore, compared to male patients, female stroke patients had a lower cumulative death rate at 12 months [HR: 0.777, 95% CI, 0.628-0.963]. Conclusion: Our study identified sex differences in stroke-related disability, recurrence, and death and attempted to explain the causes of these differences. Our study clearly showed that a large proportion of this difference can be attributed to age, socioeconomic factors, lifestyle habits and medical history, which are confounded by sex, rather than sex per se.