Risk factors for cognitive impairment after ischemic stroke:a retrospective case series study / 国际脑血管病杂志

ABSTRACT

Objective To investigate the risk factors for cognitive impairment after ischemic stroke.Metbods The Mini-Mental State Examination (MMSE) scale was used to screen the patients with cognitive impairment within 3 days after the onset of ischemic stroke.The patients were divided into either a cognitive impairment group or a non-cognitive impairment group according to the MMSE scores.Demographics,vascular risk factors,and clinical data were compared in both groups.The independent risks factor for cognitive impairment after ischemic stroke were analyzed by using multivariate logistic regression analysis.Results A total of 202 patients with ischemic stroke were included in the study,in which 48 (23.8％) were in the cognitive impairment group.The proportions of age (66 ± 6 years vs.57 ± 5 years; t =2.231,P =0.038),previous diabetes (39.6％ vs. 18.2％ ; x2 =9.388,P =0.003 ),history of stroke or transient ischemic attack (39.6％ vs.20.8％;x2 =6.856,P=0.007),and the baseline National Institutes of Health Scale scores (11.8 ±2.4 vs,8.1 ± 1.9; t =2.046,P =0.043),as well as serum homocysteine (29.2± 7.8 μmol/L vs.19.9 ±6.5 μmol/L; t =2.781,P =0.008),uric acid (401.5 ± 51.1 μmol/L vs.312.4 ± 60.7 μmol/L; t =3.042,P=0.003),and C-reactive protein (18.4 ±5.2 μmol/L vs.11.3±4.2 μmol/L;t=2.903,P=0.004)levels in the cognitive impairment group were significantly higher than those in the non-cognitive impairment group.Multivariate logistic regression analysis showed that tha age (odds ratio [OR] 1.812,95％ confidence interval [CI] 1.138 -3.205; P =0.039),history of diabetes (OR 2.520,95％ CI 1.854 -4.111; P =0.025),history of stroke or transient ischemic attack (OR 4.232,95％ CI 1.905 - 8.582; P =0.014),as well as the increased levels of serum homocysteine (OR 3.618,95％ CI 2.061 -6.312; P =0.018),uric acid (OR 2.179,95％ CI 1.654 - 3.836; P =0.031),and C-reactive protein (OR 2.716,95％ CI 1.507 - 5.552; P =0.022)were the independent risk factors for cognitive impairment after ischemic stroke.Conclusions The incidence of cognitive impairment after the onset of ischemic stroke was higher.The age and the history of stroke or transient ischemic attack and diabetes,as well as the increased levels of serum C-reactive protein,uric acid,and homocysteine were the independent risk factors for cognitive impairment after ischemic stroke.