Risk factors of post-stroke disability in patients with acute cerebral infarction / 中华全科医师杂志

ABSTRACT

Objective To analyze the risk factors of post-stroke disability in patients with acute cerebral infarction.Methods Total 1 137 consecutive patients with acute cerebral infarction admitted in Department of Neurology, General Hospital of Jinan Military Region, were prospectively recruited from August 2010 to August 2014.According to Oxfordshire Community Stroke Project(OCSP), 275 patients were classified as total anterior circulation infarction, 377 as partial anterior circulation infarction,305 as posterior circulation infarction and 180 as lacunar infarction.The baseline data including age, gender, National Institute of Health Stroke Scale ( NIHSS) score were recorded.Recovery was assessed by modified Rankin Scale ( mRS) 6 months after stroke by telephone interview ( mRS≤2good prognosis, 2risk factors of disability 6 months after disease onset.Results During the study period 123 patients died.Among remaining 1 014 patients, 638 were males and 376 were females;and 283 patients were disabled after stroke, including 156 males and 127 females.The disability rate in females were significantly higher than that in males(33.8%vs.24.5%,χ2 =9.86, P=0.002).Univariate analysis also showed that age≥73 years(P=0.000), NIHSS score≥8 (P=0.000), myocardial infarction(P=0.001), congestive heart failure(P=0.000), diabetes(P=0.002), artrial fibrilation(P=0.000), hyperlipidemia(P =0.003), recurrent cerebral infarction(P =0.000), smoking(P =0.003), alcohol drinking(P =0.004) and lacunar infarction(P =0.000) were correlated with disability.Multivariate regression analysis showed that female sex ( OR=1.681, 95%CI1.183-2.390, P=0.004), age≥73 years (OR=3.955, 95%CI2.708-5.776, P=0.000), NIHSS score≥8 (OR=7.473, 95%CI5.154-10.837, P=0.000), recurrent cerebral infarction (OR=3.149, 95%CI2.150 -4.614, P =0.000), atrial fibrillation ( OR =2.558, 95%CI1.465 -4.466, P =0.001), diabetes (OR=2.010, 95%CI1.415-2.855, P=0.000) were independent risk factors of post-disability 6 months after onset of cerebral infarction, while lacunar infarction ( OR =0.226, 95%CI0.112-0.456, P =0.000 ) was a protective factor.Conclusion Female gender along with other risk factors are associated with the post-stroke disability in patients with acute cerebral infarction.