Department of Neurology, The Second Hospital of Hebei Medical University, No.215 Hepingxilu, Xinhua District, Shijiazhuang, 050000, Hebei, China.
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.6 Tiantanxili, Dongcheng District, Beijing, 100050, China.
J Neurol. 2018 Apr;265(4):942-948. doi: 10.1007/s00415-018-8793-z. Epub 2018 Feb 20.
The previous studies on the association between marital status and stroke outcomes were rare. Furthermore, the existing studies mostly focused on the protective effect of marriage on survival. We conducted the study to evaluate the association between marital status and adverse stroke outcomes in patients with AIS based on China national stroke registry.
This was a multicenter, prospective cohort study of patients with AIS. Patients were classified into two groups based on marital status at admission: married and unmarried. The primary outcomes included all-cause mortality, stroke recurrence, combined endpoint, and stroke disability. Stroke disability was defined as modified Rankin Scale of 2-6.
Of 12,118 patients, 1220 were unmarried and 10,898 married. Unmarried patients had higher proportion of 1-year post-stroke events than married patients did. As compared with being unmarried, the adjusted odds ratios with 95% confidence interval of being married for outcomes were as follows: 0.70 (0.58-0.84) for all-cause mortality, 0.78 (0.66-0.91) for stroke recurrence, 0.77 (0.66-0.90) for combined endpoint, and 0.75 (0.65-0.88) for stroke disability. Interactions between marital status and education were significant for all outcomes except for stroke disability.
Marital status was associated with all adverse stroke outcomes in patients with acute ischemic stroke, especially in those with middle-school education.
先前关于婚姻状况与卒中结局之间关联的研究较少。此外，现有的研究大多集中在婚姻对生存的保护作用上。我们基于中国国家卒中登记处，开展了这项研究，旨在评估婚姻状况与急性缺血性卒中患者不良卒中结局之间的关系。
这是一项多中心、前瞻性队列研究，纳入了急性缺血性卒中患者。根据入院时的婚姻状况，将患者分为两组：已婚和未婚。主要结局包括全因死亡率、卒中复发、联合终点和卒中残疾。卒中残疾定义为改良 Rankin 量表评分为 2-6 分。
在 12118 名患者中，1220 名未婚，10898 名已婚。与已婚患者相比，未婚患者发生 1 年后卒中事件的比例更高。与未婚相比，已婚患者发生以下结局的调整比值比（95%置信区间）分别为：全因死亡率为 0.70（0.58-0.84），卒中复发为 0.78（0.66-0.91），联合终点为 0.77（0.66-0.90），卒中残疾为 0.75（0.65-0.88）。婚姻状况与教育程度之间的交互作用对除卒中残疾以外的所有结局均有统计学意义。
婚姻状况与急性缺血性卒中患者的所有不良卒中结局相关，尤其是在中学教育程度的患者中。
