ABSTRACT
Objective:To investigate the triggering factors of ischemic stroke and their correlation with stroke severity and traditional risk factors.Methods:The clinical data of patients with ischemic stroke within 2 weeks of the onset were collected retrospectively. They were divided into two groups according to the questionnaire of triggering factors. The demographic and baseline data of the two groups were compared. According to the National Institutes of Health Stroke Scale (NIHSS) score, the patients were divided into low NIHSS score group (≤8) and high NIHSS score group (>8). The demographic and baseline data were compared. Multivariate logistic regression analysis was used to determine the independent related factors of the existence of triggering factors in patients with ischemic stroke and the correlation between the existence of triggering factors and the severity of stroke. Results:A total of 217 patients were enrolled in the study. Their age was 63.4±12.8 years and 148 were male (68.2%). One hundred and nine patients had at least one triggering factor. Common triggering factors were sleep disorders (46.8%), infection (18.4%), and missed medication (13.8%). Multivariate logistic regression analysis showed that after adjusting for confounding factors, diabetes mellitus (odds ratio [ OR]2.496, 95% confidence interval [ CI]1.347-4.626; P=0.047), large artery atherosclerosis ( vs. small vessel occlusion: OR 2.168, 95% CI 1.060-4.343; P=0.034) and baseline NIHSS score (the fourth quartile vs. the first quartile: OR 2.320, 95% CI 1.043-5.162; P=0.039) were independently associated with the existence of triggering factors in patients with ischemic stroke, and any of the triggering factors was independently associated with stroke severity ( OR 2.042, 95% CI 1.106-3.770; P=0.023). Conclusion:Diabetes and the severity of stroke are associated with the existence of triggering factors in patients with ischemic stroke. Stroke severity in ischemic stroke patients with triggering factors is more severe.
ABSTRACT
Epidemiological data,clinical observation and animal experiments have shown that cold wave is closely associated with the onset of stroke.When a population with stroke etiology or risk factors is under pre-stroke state,they will have stroke under the influence of various inducing factors.Cold wave is the external factor that causes the body to enter the pre-stroke state and there are many possible mechanisms.The drug intervention of stroke-prone hypertensive rats at 1 week before the cold wave can reduce the occurrence of stroke during cold wave,suggesting that it is of great significance to conduct preventive intervention to the pre-stroke population before the cold wave coming.
ABSTRACT
[Objective] To study the factors relative to the delayed diagnosis of spontaneous dual arteriovenous fistulas (DAVF) and its influence on the prognosis.[Methods] We included 102 continuous patients diagnosed DAVF in the First Affiliated Hospital of Sun Yat-sen University,and analyzed the correlative factors and impact on outcome of diagnostic delay.Outcome was whether symptoms were non-improvement,improvement or restoration at discharge.[Results] Median delay from onset to diagnosis was 3 months (interquartile range,1 to 6).Compared with patients diagnosed carlier(diagnose time≤3 months),patients diagnosed later (diagnose time ＞ 3 months) had a lower frequency of headache (P =0.012),ptosis (P =0.035) and parenchymal lesions (P =0.001),a higher frequency of conjunctival congestion (P =0.004),tinnitus (P =0.021),visual dysfunction (P ＜ 0.001),isolated visual dysfunction (P =0.007) and delayed imaging scan (P ＜ 0.001),a higher frequency of endovascular treatment,and a lower frequency of improvement or restoration at discharge (P =0.033),in which patients with visual dysfunction had a lower frequency of improvement or restoration than those without visual dysfunction (P =0.023).Compared to those with visual dysfunction and other symptoms,patients with isolated visual dysfunction had a higher frequency of onset with paroxysmal blurring or blinding (P ＜ 0.001),two eyes involved (P ＜ 0.001) and more severe visual loss (P =0.057),a higher frequency of draining into transversesigmoid sinus (P ＜ 0.001) instead of cavernous sinus (P ＜ 0.001),and suffered intracranial hypertension all (median intracranial pressure,405 mmH2O;interquartile range,370 ～ 512 mmH2O).However,no statistically significant differences were found in the frequency of improvement or restoration at discharge between two groups (P =0.739).[Conclusion] Diagnostic delay was considerable in this cohort and was associated with outcome,especially in patients with visual dysfunction.