Zhuo Yuanyuan, Wu Jiaman, Qu Yimin, Yu Haibo, Huang Xingxian, Zee Benny, Lee Jack, Yang Zhuoxin
Shenzhen Traditional Chinese Medicine Hospital.
Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University.
Medicine (Baltimore). 2020 Jun 26;99(26):e20830. doi: 10.1097/MD.0000000000020830.
To identify the clinical risk factors and investigate the efficacy of a classification model based on the identified factors for predicting 2-year recurrence after ischemic stroke.From June 2017 to January 2019, 358 patients with first-ever ischemic stroke were enrolled and followed up in Shenzhen Traditional Chinese Medicine Hospital. Demographic and clinical characteristics were recorded by trained medical staff. The outcome was defined as recurrence within 2 years. A multivariate logistic regression model with risk factors and their interaction effects was established and evaluated.The mean (standard deviation) age of the participants was 61.6 (12.1) years, and 101 (28.2%) of the 358 patients were female. The common comorbidities included hypertension (286 patients, 79.9%), diabetes (148 patients, 41.3%), and hyperlipidemia (149 patients, 41.6%). The 2-year recurrence rate was 30.7%. Of the 23 potential risk factors, 10 were significantly different between recurrent and non-recurrent subjects in the univariate analysis. A multivariate logistic regression model was developed based on 10 risk factors. The significant variables include diabetes mellitus, smoking status, peripheral artery disease, hypercoagulable state, depression, 24 h minimum systolic blood pressure, 24 h maximum diastolic blood pressure, age, family history of stroke, NIHSS score status. The area under the receiver operating characteristic curve (ROC) was 0.78 (95% confidence interval: 0.726-0.829) with a sensitivity of 0.61 and a specificity of 0.81, indicating a potential predictive ability.Ten risk factors were identified, and an effective classification model was built. This may aid clinicians in identifying high-risk patients who would benefit most from intensive follow-up and aggressive risk factor reduction.The clinical trial registration number: ChiCTR1800019647.
识别临床风险因素,并研究基于所识别因素的分类模型对缺血性中风后2年复发的预测效果。2017年6月至2019年1月,358例首次发生缺血性中风的患者在深圳市中医院入组并接受随访。由经过培训的医务人员记录人口统计学和临床特征。结局定义为2年内复发。建立并评估了包含风险因素及其交互作用的多因素逻辑回归模型。参与者的平均(标准差)年龄为61.6(12.1)岁,358例患者中有101例(28.2%)为女性。常见合并症包括高血压(286例患者,79.9%)、糖尿病(148例患者,41.3%)和高脂血症(149例患者,41.6%)。2年复发率为30.7%。在23个潜在风险因素中,单因素分析显示10个因素在复发组和未复发组之间存在显著差异。基于10个风险因素建立了多因素逻辑回归模型。显著变量包括糖尿病、吸烟状况、外周动脉疾病、高凝状态、抑郁、24小时最低收缩压、24小时最高舒张压、年龄、中风家族史、美国国立卫生研究院卒中量表(NIHSS)评分状况。受试者工作特征曲线(ROC)下面积为0.78(95%置信区间:0.726 - 0.829),灵敏度为0.61,特异度为0.81,表明具有潜在预测能力。识别出10个风险因素,并建立了有效的分类模型。这可能有助于临床医生识别出从强化随访和积极降低风险因素中获益最大的高危患者。临床试验注册号:ChiCTR1800019647。