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首次缺血性卒中后与卒中复发相关的院内医学并发症:一项来自中国国家卒中登记系统的前瞻性队列研究。

In-hospital medical complications associated with stroke recurrence after initial ischemic stroke: A prospective cohort study from the China National Stroke Registry.

作者信息

Wang Penglian, Wang Yilong, Zhao Xingquan, Du Wanliang, Wang Anxin, Liu Gaifen, Liu Liping, Ji Ruijun, Wang Chunxue, Dong Kehui, Wang Yongjun

机构信息

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University Center of Stroke, Beijing Institute for Brain Disorders Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease China National Clinical Research Center for Neurological Diseases, Beijing, China.

出版信息

Medicine (Baltimore). 2016 Sep;95(37):e4929. doi: 10.1097/MD.0000000000004929.

Abstract

In-hospital medical complications are common and strongly associated with the risk of death and dependency in stroke patients. Whether similar associations extend to stroke recurrence is unclear. We prospectively and systematically investigated whether in-hospital medical complications are associated with recurrent stroke of patients in the China National Stroke Registry (CNSR). We examined patients with initial ischemic stroke enrolled in CNSR between 2007 and 2008. Recurrent stroke at 3, 6, and 12 months post-stroke was used as stroke outcome. Medical complications were associated with stroke outcomes using multivariable logistic regression.Of the 7593 study patients, recurrent stroke occurred in 1115 (14.7%) within 12 months after stroke onset. In-hospital medical complications were independent risk factors for stroke recurrence in patients with initial ischemic stroke at 3 months (adjusted odds ratio (OR) = 2.19, 95% confidence interval (CI) 1.85 to 2.60), 6 months (adjusted OR = 2.04, 95% CI 1.74 to 2.38), and 12 months (adjusted OR = 1.88; 95% CI 1.62 to 2.19) after onset. The persistence of secondary prevention medications in patients with complications was lower than that in patients without complications.Stroke recurrence post-acute ischemic stroke is significantly associated with in-hospital medical complications.

摘要

住院期间的医疗并发症很常见,并且与卒中患者的死亡和依赖风险密切相关。类似的关联是否延伸至卒中复发尚不清楚。我们进行了前瞻性和系统性研究,以调查中国国家卒中登记系统(CNSR)中住院期间的医疗并发症是否与患者的卒中复发相关。我们研究了2007年至2008年期间纳入CNSR的初发缺血性卒中患者。卒中后3个月、6个月和12个月的卒中复发被用作卒中结局。使用多变量逻辑回归分析医疗并发症与卒中结局的关联。在7593例研究患者中,1115例(14.7%)在卒中发病后12个月内出现卒中复发。住院期间的医疗并发症是初发缺血性卒中患者在发病后3个月(调整比值比(OR)=2.19,95%置信区间(CI)1.85至2.60)、6个月(调整OR=2.04,95%CI 1.74至2.38)和12个月(调整OR=1.88;95%CI 1.62至2.19)卒中复发的独立危险因素。有并发症患者二级预防药物的持续使用率低于无并发症患者。急性缺血性卒中后的卒中复发与住院期间的医疗并发症显著相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f499/5402614/5e274aeaa3c7/medi-95-e4929-g001.jpg

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