Stroke History is an Independent Risk Factor for Poor Prognosis in Ischemic Stroke Patients: Results from a Large Nationwide Stroke Registry

Haiqiang Qin; Penglian Wang; Runhua Zhang; Miaoxin Yu; Guitao Zhang; Gaifen Liu; Yongjun Wang

doi:10.2174/1567202617666200817141837

Stroke History is an Independent Risk Factor for Poor Prognosis in Ischemic Stroke Patients: Results from a Large Nationwide Stroke Registry

Curr Neurovasc Res. 2020;17(4):487-494. doi: 10.2174/1567202617666200817141837.

Authors

Haiqiang Qin¹, Penglian Wang¹, Runhua Zhang¹, Miaoxin Yu¹, Guitao Zhang¹, Gaifen Liu¹, Yongjun Wang¹

Affiliation

¹ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Abstract

Background: There is some controversy whether stroke history is an independent risk factor for poor prognosis of stroke or not. This study aimed to investigate the difference of mortality, disability and recurrent rate of ischemic stroke patients without and with stroke history, as well as to explore the effect of stroke history on stroke prognosis.

Methods: We analyzed patients with ischemic stroke enrolled in the China National Stroke Registry which was a nationwide, multicenter, and prospective registry of consecutive patients with acute cerebrovascular events from 2007 to 2008. Multivariable logistic regression was performed to assess the risk of worse prognosis of stroke history in patients with ischemic stroke.

Results: A total of 8181(65.9%) patients without stroke history and 4234(34.1%) patients with stroke history were enrolled in the study. The mortality, recurrence, modified Rankin Scale (mRS) 3-6 rate was 11.4%, 14.7% and 28.5% respectively at 1 year for patients without stroke history, which was significantly lower than that of 17.3%, 23.6%, 42.1% in patients with stroke history, respectively. Multivariable analysis showed that patients with stroke history had higher risk of death [odds ratio (OR) 1.34,95% confidence interval (CI) 1.17-1.54], recurrence (OR 1.47, 95 % CI 1.31-1.65) and mRS 3-6 (OR 1.49,95% CI 1.34-1.66) at 1 year.

Conclusion: After adjusting for the potential confounders, stroke history was still an independent risk factor for poor prognosis of ischemic stroke, which further emphasizes the importance of secondary prevention of ischemic stroke. The specific causes of poor prognosis in patients with history of stroke need to be furtherly investigated.

Keywords: Ischemic stroke; disability; mortality; prognosis; registry; risk factors.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Brain Ischemia / diagnosis*
Brain Ischemia / mortality*
China / epidemiology
Female
Follow-Up Studies
Humans
Ischemic Stroke / diagnosis*
Ischemic Stroke / mortality*
Male
Middle Aged
Prognosis
Prospective Studies
Registries*
Risk Factors

Grants and funding

This work was financially supported by National key R & D Plan of Ministry of Science and Technology of China (Grant no. 2016YFC1301604, 2017YFC1307702); National Natural Science Foundation of China (Grant no. 81870907); National key R & D Plan of Ministry of Science and Technology of China (Grant no. 2016YFC0901002, 2018YFC- 1312303), Ministry of Science and Technology and the Ministry of Health of the People’s Republic of China (Grant no. 2006BA101A11, and 2009CB521905), National Science and Technology Major Project (Grant no. 2017ZX0930- 4018), Capital’s Funds for Health Improvement and Research (Grant no. 2020-1-2041).