Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada. ; Division of Clinical Epidemiology, Department of Internal Medicine, McGill University Health Centre, McGill University, Montreal, Quebec, Canada.
Division of Clinical Epidemiology, Department of Internal Medicine, McGill University Health Centre, McGill University, Montreal, Quebec, Canada.
J Clin Neurol. 2014 Jan;10(1):1-9. doi: 10.3988/jcn.2014.10.1.1. Epub 2014 Jan 6.
There is a variety of stroke risk factors, and engaging individuals in reducing their own personal risk is hugely relevant and could be an optimal dissemination strategy. The aim of the present study was to estimate the stroke risk for specific combinations of health- and lifestyle-related factors, and to develop a personalized stroke-risk assessment tool for health professionals and the general population (called the MyRisk_Stroke Calculator).
This population-based, longitudinal study followed a historical cohort formed from the 1992 or 1998 Santé Québec Health Surveys with information for linkage to health administrative databases. Stroke risk factors were ascertained at the time of survey, and stroke was determined from hospitalizations and death records. Cox proportional hazards models were used, modeling time to stroke in relationship to all variables.
A total of 358 strokes occurred among a cohort of 17805 persons (men=8181) who were followed for approximately 11 years (i.e., -200000 person-years). The following regression parameters were used to produce 10-year stroke-risk estimates and assign risk points: for age (1 point/year after age 20 years), male sex (3 points), low education (4 points), renal disease (8 points), diabetes (7 points), congestive heart failure (5 points), peripheral arterial disease (2 points), high blood pressure (2 points), ischemic heart disease (1 point), smoking (8 points), >7 alcoholic drinks per week (3 points), low physical activity (2 points), and indicators of anger (4 points), depression (4 points), and anxiety (3 points). According to MyRisk_Stroke Calculator, a person with <50, 75, and 90 risk points has a 10-year stroke risk of <3%, 28%, and >75%, respectively.
The MyRisk_Stroke Calculator is a simple method of disseminating information to the general population about their stroke risk.
存在多种卒中危险因素,让个体参与到降低自身个体风险中具有重要意义,并且可能是一种最佳的传播策略。本研究旨在估计与健康和生活方式相关因素的特定组合的卒中风险,并为卫生专业人员和普通人群开发一种个性化的卒中风险评估工具(称为 MyRisk_Stroke 计算器)。
这项基于人群的纵向研究随访了来自 1992 年或 1998 年的 Santé Québec 健康调查的历史队列,这些调查信息可与健康管理数据库进行链接。在调查时确定卒中危险因素,并根据住院和死亡记录确定卒中情况。使用 Cox 比例风险模型,根据所有变量来模拟与卒中相关的时间。
在一个由 17805 人(男性 8181 人)组成的队列中发生了 358 例卒中,该队列随访了大约 11 年(即 200000 人年)。使用以下回归参数来生成 10 年卒中风险估计值并分配风险点:年龄(每增加 1 岁增加 1 分,年龄超过 20 岁)、男性(3 分)、低教育程度(4 分)、肾脏疾病(8 分)、糖尿病(7 分)、充血性心力衰竭(5 分)、外周动脉疾病(2 分)、高血压(2 分)、缺血性心脏病(1 分)、吸烟(8 分)、每周>7 份含酒精饮料(3 分)、低身体活动(2 分)以及愤怒(4 分)、抑郁(4 分)和焦虑(3 分)的指标。根据 MyRisk_Stroke 计算器,如果一个人的风险点小于 50、75 和 90,则他在 10 年内的卒中风险分别为<3%、28%和>75%。
MyRisk_Stroke 计算器是向普通人群传播有关其卒中风险信息的简单方法。