Zakład Rehabilitacji Medycznej i Fizjoterapii Klinicznej, Pomorski Uniwersytet Medyczny, ul. Broniewskiego 14, 71-460 Szczecin, Poland.
Neurol Neurochir Pol. 2020;54(2):150-155. doi: 10.5603/PJNNS.a2020.0018. Epub 2020 Feb 26.
In Poland, it is widely believed that the outlook for ischaemic stroke patients is gradually improving due to the development of a network of stroke wards and other dedicated hospital units throughout the country. However, a study by Shah et al., reporting a significant increase in mortality from ischaemic stroke in several European countries including Poland, contradicts this belief. Therefore, the aim of this study was to determine the risk factors for death in patients with recent ischaemic stroke among a population of patients from Western Pomerania, a region in north-western Poland.
This retrospective study involved 2,374 patients with recent ischaemic stroke. Mortality was defined as death within 30 days of admission to hospital. Patients who died in hospital during this period were defined as deceased, while those who survived beyond this time were classified as alive.
We found that compared to ischaemic stroke patients who survived, the group of ischaemic stroke patients who died included a higher number of patients who smoked cigarettes (OR = 6.08 in univariable model; OR = 6.22 in adjusted model), had hypertension (OR = 2.57; OR = 1.85), had a history of previous stroke (OR = 2.63; OR = 2.14), had coronary heart disease (OR = 1.78; OR=1.36), and were older (OR = 1.06; OR = 1.05). For all these factors, p-value was lower than 0.001. Females had a higher risk of death (OR = 1.48, p < 0.001; OR = 1.35, p = 0.01). For dyslipidemia, only univariable model was statistically significant (OR = 1.38, p < 0.001).
Older age, female sex, dyslipidemia, hypertension, coronary heart disease, and smoking are not only recognised risk factors for ischaemic stroke, but also risk factors associated with an unfavourable prognosis following stroke.
在波兰，人们普遍认为，由于全国范围内建立了脑卒中病房和其他专门的医院科室网络，缺血性脑卒中患者的预后正在逐渐改善。然而，Shah 等人的研究报告称，包括波兰在内的几个欧洲国家缺血性脑卒中的死亡率显著上升，这与上述观点相矛盾。因此，本研究旨在确定波兰西北部西波美拉尼亚地区缺血性脑卒中患者近期预后的死亡风险因素。
这是一项回顾性研究，共纳入 2374 例近期缺血性脑卒中患者。将死亡率定义为住院 30 天内死亡。在此期间在医院死亡的患者定义为死亡，而存活超过此时间的患者定义为存活。
与存活的缺血性脑卒中患者相比，死亡组患者中吸烟的比例更高（单变量模型中 OR = 6.08；调整模型中 OR = 6.22），患有高血压（OR = 2.57；OR = 1.85）、有既往脑卒中史（OR = 2.63；OR = 2.14）、冠心病（OR = 1.78；OR = 1.36），年龄较大（OR = 1.06；OR = 1.05）。对于所有这些因素，p 值均<0.001。女性死亡风险更高（OR = 1.48，p<0.001；OR = 1.35，p = 0.01）。对于血脂异常，仅单变量模型具有统计学意义（OR = 1.38，p<0.001）。
年龄较大、女性、血脂异常、高血压、冠心病和吸烟不仅是缺血性脑卒中的公认危险因素，也是脑卒中后预后不良的相关危险因素。
