Dementia increases the risk of death in stroke patients: A retrospective cohort-based risk score model study

Xinya Su; Dongfeng Pan; Hua Meng; Wenwen Lu; Xingtian Wang; Zhuo Liu; Yuhui Geng; Xiaojuan Ma; Peifeng Liang

doi:10.1016/j.jstrokecerebrovasdis.2023.107337

Dementia increases the risk of death in stroke patients: A retrospective cohort-based risk score model study

J Stroke Cerebrovasc Dis. 2023 Nov;32(11):107337. doi: 10.1016/j.jstrokecerebrovasdis.2023.107337. Epub 2023 Sep 6.

Authors

Xinya Su¹, Dongfeng Pan², Hua Meng¹, Wenwen Lu¹, Xingtian Wang¹, Zhuo Liu¹, Yuhui Geng¹, Xiaojuan Ma¹, Peifeng Liang³

Affiliations

¹ School of Public Health and Management, Ningxia Medical University, Yinchuan, China; Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, China.
² Department of Emergency Medicine, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China.
³ Department of Medical Records and Statistics, People's Hospital of Ningxia Hui Autonomous Region, 301 Zhengyuan North Street, Yinchuan, Ningxia 750002, China. Electronic address: doctor_pf@126.com.

PMID: 37677896
DOI: 10.1016/j.jstrokecerebrovasdis.2023.107337

Abstract

Background: The relationship between dementia and the mortality of stroke is a significant concern for patients and careers. However, there are few research about it in China and a lack of reliable data on the risk of dementia. We aim to analyze and compare the risk of death in stroke patients with and without dementia. Further investigation into the predictive value of dementia for stroke death.

Methods: All patients with stroke who were identified among residents of Ningxia, between January 1, 2014 to December 31, 2021, set death or May 22, 2022 as the observation endpoint. All patients were screened by 1:4 propensity score matching (PSM). The association between dementia and all-cause mortality was evaluated using Cox regression with survival time. Evaluation of the predictive value of dementia using decision curve analysis (DCA) and clinical impact curve (CIC) curves.

Result: Mortality of stroke with dementia is 45.4% and without dementia is 13.8%, further calculated one-year mortality is higher in the patients with dementia than without dementia (17.3%vs. 5.4%, p < 0.001). Stroke patients with dementia had a 3.74 times higher risk of death (95% CI = 3.29,4.26) and had a shorter survival time than those without dementia. Dementia was an independent predictor of death in all models (hazard ratio [HR]=3.77,95%CI: 3.31-4.30, p < 0.001). DCA and CIC curves indicated that dementia has a high value in predicting the risk of death in stroke patients.

Conclusion: Dementia is an independent risk factor for death and reduces survival time in stroke patients.

Keywords: Dementia; Mortality; Predictors; Risk factors; Stroke.