Risk factors affecting the 1-year outcomes of minor ischemic stroke: results from Xi’an stroke registry study of China

Abstract

Background The prevalence of stroke recurrence, disability, and all-cause mortality of patients with minor ischemic stroke (MIS) remains problematic. The aim of the present study was to identify risk factors associated with adverse outcomes at 1 year after MIS in the Xi’an region of China. Methods This prospective cohort study included MIS patients above 18 years old with National Institutes of Health Stroke Scale (NIHSS) score ≤ 3 who were treated in any of four hospitals in Xi’an region of China between January and December 2015. The 1-year prevalence of stroke recurrence, disability, and all-cause mortality were evaluated, respectively. Multivariate logistic regression analysis was performed to assess the association between the identified risk factors and clinical outcomes. Results In this study, 131(10.5%, 131/1252) patients were lost to follow-up at 1 year. A total of 1121 patients were included for analysis, the prevalence of stroke recurrence, disability, and all-cause mortality at 1 year after MIS were 3.4% (38/1121), 9.3% (104/1121), and 3.3% (37/1121), respectively. Multivariate logistic regression analysis identified age, current smoking, and pneumonia as independent risk factors for stroke recurrence. Age, pneumonia, and alkaline phosphatase were independent risk factors for all-cause mortality. Independent risk factors for disability were age, pneumonia, NIHSS score on admission, and leukocyte count. Conclusions The 1-year outcomes of MIS in Xi’an region of China were not optimistic, especially with a high prevalence of disability. The present study indicated that age and pneumonia were the common independent risk factors affecting the 1-year outcomes of MIS in Xi’an region of China.

Alkaline phosphatase and mortality in stroke patients: a systematic review

“…Stroke was defined by the World Health Organization (WHO) clinical criteria ( 19 ) in five of the nine articles ( 10 , 11 , 13 , 14 , 16 ), as rapidly developing clinical signs of focal (or global) disturbance of cerebral function, lasting more than 24 hours or leading to death with no apparent cause other than of vascular origin. Five studies ( 13 - 16 , 18 ) confirmed the clinical diagnosis through brain imaging [computed tomography (CT) or magnetic resonance imaging (MRI) scan]. Not all articles studied populations with the same type of stroke.…”

“…Not all articles studied populations with the same type of stroke. Three studies ( 14 , 16 , 17 ) focused on mortality purely after ischemic stroke, two ( 11 , 13 ) purely after hemorrhagic stroke and four ( 10 , 12 , 15 , 18 ) after either hemorrhagic or ischemic stroke. Regarding the studies that considered patients who suffered a hemorrhagic stroke, three studies excluded hemorrhagic strokes caused by subarachnoid hemorrhage (SAH) ( 10 , 12 , 13 ), while the other two ( 15 , 18 ) included both SAH and spontaneous intracerebral hemorrhage as hemorrhagic strokes.…”

“…From those that focused solely on ischemic stroke, two ( 15 , 18 ) also included TIA, whilst Zhong et al ( 14 ) excluded patients diagnosed with TIA. Liu et al ( 16 ) specifically evaluated patients with minor ischemic stroke, defined as a National Institutes of Health Stroke Scale (NIHSS) score at admission lower or equal to 3. Two articles ( 10 , 17 ) detailed the aetiology of the ischemic stroke events according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria ( 20 ).…”

Early Hemorrhagic Transformation after Reperfusion Therapy in Patients with Acute Ischemic Stroke: Analysis of Risk Factors and Predictors

“…In general, strokes can occur for several reasons, including modifiable risk factors (diet, physical inactivity, comorbidities, and environmental conditions), as well as nonmodifiable risk factors (age, genetic predisposition, and gender) [14,15]. Moreover, not only are these risk factors increasing the risk of having a stroke, but studies have shown that they are also associated with severe outcomes or stroke recurrence [16,17].…”

One-year recurrence of stroke and death in Lebanese survivors of first-ever stroke: Time-to-Event analysis

“…Stroke may affect the immunological status and level of independence of survivors; thus, severe stroke patients are prone to infections leading to post-stroke readmissions because of recurrent aspiration pneumonia and urinary catheterizations. This condition causes an increase in disability, immobility, and elevated inflammatory markers that contribute to atherogenesis and thrombosis, leading to long-term sequelae, recurrent stroke, and subsequent death (110,(140)(141)(142)(143)(144)(145).…”