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年龄对非致残性缺血性脑血管事件的临床特征和 1 年结局的影响:一项多中心前瞻性队列研究。

Impact of age on clinical characteristics and 1-year outcomes of non-disabling ischemic cerebrovascular events: A multicenter prospective cohort study.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China.

Department of Neurology, The First Affiliated Hospital of Northwest University, Xi'an No.1 Hospital, Xi'an, China.

出版信息

BMC Geriatr. 2024 Oct 26;24(1):884. doi: 10.1186/s12877-024-05491-3.

Abstract

BACKGROUND

The exploration of age-related clinical features and adverse outcomes of non-disabling ischemic cerebrovascular disease (NICE) has been largely unaddressed in current research. This study aimed to analyze the differences in clinical characteristics and prognostic outcomes of NICE across various age groups, utilizing data from the Xi'an Stroke Registry Study in China.

METHODS

The age distribution of NICE was categorized into four groups: age ≤ 54 years, age 55-64 years, age 65-74 years, and age ≥ 75 years. Multivariate Cox logistic regression analysis was employed to evaluate the 1-year risk of outcome events in each age group of patients with NICE. A subgroup analysis was conducted to explore interaction factors influencing age-dependent outcomes in patients with NICE.

RESULTS

This study included 1,121 patients with NICE aged between 23 and 96 years, with an average age of 63.7 ± 12.2 years. Patients aged ≥ 75 years had a higher proportion of women, lower education levels, and a greater likelihood of having urban employee medical insurance. Those aged < 55 years had a higher prevalence of smoking, while individuals aged > 65 years showed a higher prevalence of comorbidities. Furthermore, there was a significant decrease in body mass index among patients aged ≥ 75 years. Laboratory tests indicated well-controlled blood lipids, liver function, and inflammation across all age groups, but renal function was notably reduced in patients with NICE aged ≥ 75 years. Adjusting for potential confounding factors revealed a significant increase in the one-year risk of all-cause mortality and poor prognosis among patients aged ≥ 75 years compared to those aged < 55 years, with no significant gender difference observed. Subgroup analysis indicated that patients with NICE who consumed alcohol were more prone to experience all-cause mortality with advancing age.

CONCLUSIONS

Age significantly influences the clinical characteristics and prognostic outcomes of NICE patients. Clinicians should consider age-specific characteristics when diagnosing, treating, and developing prevention strategies. Tailored prevention and treatment strategies for different age groups can enhance prognosis and reduce adverse outcomes in NICE patients.

摘要

背景

目前的研究尚未充分探讨与年龄相关的非致残性缺血性脑血管病(NICE)的临床特征和不良结局。本研究旨在利用中国西安脑卒中登记研究的数据,分析不同年龄组 NICE 的临床特征和预后结局差异。

方法

将 NICE 的年龄分布分为四组:年龄≤54 岁、年龄 55-64 岁、年龄 65-74 岁和年龄≥75 岁。采用多变量 Cox 逻辑回归分析评估每组 NICE 患者 1 年结局事件风险。进行亚组分析以探讨影响 NICE 患者年龄相关结局的交互因素。

结果

本研究纳入了 1121 例年龄 23-96 岁的 NICE 患者,平均年龄为 63.7±12.2 岁。年龄≥75 岁的患者中女性比例较高、受教育程度较低且更有可能参加城镇职工医疗保险。年龄<55 岁的患者吸烟率较高,而年龄>65 岁的患者合并症发生率较高。此外,年龄≥75 岁的患者体重指数显著下降。所有年龄组的血脂、肝功能和炎症指标控制良好,但年龄≥75 岁的 NICE 患者肾功能明显下降。调整潜在混杂因素后发现,与年龄<55 岁的患者相比,年龄≥75 岁的患者 1 年全因死亡率和预后不良风险显著增加,且性别差异无统计学意义。亚组分析表明,随着年龄的增长,饮酒的 NICE 患者更易发生全因死亡。

结论

年龄显著影响 NICE 患者的临床特征和预后结局。临床医生在诊断、治疗和制定预防策略时应考虑年龄特异性特征。针对不同年龄组制定个性化的预防和治疗策略可以改善 NICE 患者的预后并降低不良结局的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebd5/11515806/282eb7d962d9/12877_2024_5491_Fig1_HTML.jpg

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