Neurosurgery, College of Medical Sciences, Chitwan, 0977, Nepal.
F1000Res. 2021 Aug 5;10:757. doi: 10.12688/f1000research.54981.1. eCollection 2021.
Stroke is a significant global health hazard that ripples continuum multi-spectral effects to the patients as well their caretakers. Methods: We studied 28 consecutive cohorts of patients with recurrent strokes managed in our centre within the last two years. Results: The most common recurrence stroke pattern was of that of hemorrhagic to hemorrhagic subtype observed in 50% of the patients. The most common anatomical region of involvement was cortical - cortical seen in 39.28% of our cohorts. The surgical intervention was required in 17.85% whereas 42.85% of them were managed conservatively. Paradoxically, 39.28% of patients left against medical advice. The receiver operating curve (ROC) predicting mode of management was highest (area under the curve (AUC) =0.635) for compliance to therapy followed by stroke territory (AUC=0.578), age (AUC=0.457) and motor grading (AUC=0.374). The receiver operating curve (ROC) for influencing decision to leave against medical advice was highest (area under the curve (AUC) =0.861) for motor score followed by sex (AUC=0.701) and age (AUC=0.564). The analysis of variance (ANOVA) study pertaining to the mode of management was significantly connoted by the motor score and the stroke territory only. The ANOVA study pertaining to the decision to leave against medical advice was significantly governed by the motor score, stroke territory, and sex respectively. The multivariate analysis for variables governing mode of management was significant for motor score and the stroke territory only. The multivariate analysis for variables governing leave against medical advice was significant for sex, motor score and the stroke territory. Conclusions: This study aims to appraise early dichotomization of high-risk patients for recurrent strokes to reduce the continuum of neurological events as well as to mitigate the financial aspects governing stroke care.
中风是一种重大的全球健康危害，它会给患者及其护理人员带来连续的多谱效应。方法：我们研究了过去两年内在我们中心接受治疗的 28 例连续复发性中风患者。结果：最常见的复发中风模式是出血性到出血性亚型，占患者的 50%。最常见的受累解剖区域是皮质-皮质，占我们队列的 39.28%。需要手术干预的患者占 17.85%，而保守治疗的患者占 42.85%。矛盾的是，39.28%的患者违背医嘱离开。预测治疗方式的受试者工作特征曲线（ROC）最高（曲线下面积（AUC）=0.635）是对治疗的依从性，其次是中风部位（AUC=0.578）、年龄（AUC=0.457）和运动评分（AUC=0.374）。影响违背医嘱决定的 ROC 最高（曲线下面积（AUC）=0.861）是运动评分，其次是性别（AUC=0.701）和年龄（AUC=0.564）。与管理方式相关的方差分析（ANOVA）研究仅受运动评分和中风部位的显著影响。与违背医嘱决定相关的 ANOVA 研究分别受到运动评分、中风部位和性别的显著影响。与管理方式相关的多变量分析仅对运动评分和中风部位有意义。与违背医嘱决定相关的多变量分析对性别、运动评分和中风部位有意义。结论：本研究旨在评估复发性中风高危患者的早期二分法，以减少神经事件的连续谱，并减轻管理中风的经济方面的影响。
