Study On TOAST Classification And Influencing Factors Of Cerebral Infarction Patients Of Different Age Groups

BackgroundThe incidence rate of cerebral infarction has gradually increased in recent years,and has become one of the important public health problems in China and even the world.The incidence rate of cerebral infarction in young and middle-aged patients has been increasing gradually,and the problems and burdens on patients,families and society are extremely serious.But the etiology and influencing factors of cerebral infarction in different age groups are also different.At present,the etiology and influencing factors of different age groups are not fully studied.ObjectiveThrough the collection and comparative analysis of cerebral infarction cases,we can clearly identify the difference of TOAST classification and influencing factors among different age groups of cerebral infarction patients,and provide more targeted two level preventive measures for the focus group,further reduce the incidence rate of cerebral infarction.MethodsA total of 435 inpatients with cerebral infarction in Department of Neurology,Xinxiang Medical University were selected from August 2016 to September 2017.The cases were divided into two groups according to age: young and middle-aged group(18～59 years)and old-aged group(60～90 years).Review cases,collect patient case information,the data included: name,sex,age,TOAST type,history of smoking,history of drinking,obesity,blood pressure,blood lipids,blood glucose,serum homocysteine,coronary heart disease,atrial fibrillation,and carotid plaque.SPSS22.0statistical software was used to describe and analyze the collected data,P < 0.05 was statistically significant.Results1.Constituent ratio and difference of TOAST classification of cerebral infarction in different age groupsThe main type of cerebral infarction in young and middle-aged people was large artery atherosclerotic type(LAA),31.0%,followed by small artery occlusion type(SAA)22.5%,other clear cause type(SOE)16.3%,unexplained type(SUE)15.8%,cardiogenic embolism type(CE)14.4%.In the elderly group,LAA accounted for 36.9%,followed by CE(29.9%),SAA(14.2%),SOE(10.3%)and Sue(8.7%).Compared with the elderly group,the proportion of SAA(22.5%),SOE(16.3%)and SUE(15.8%)was higher in the young and middle-aged group,and the proportion of LAA(31.0%)and CE(29.9%)was lower(χ2= 23.828,P = 0.000),with statistical significance(P < 0.05).2.The differences of influencing factors in different ages and gendersCompared with young and middle-aged female patients,the proportion of smoking(76.9%)and drinking(39.5%)in male patients was higher than that in female patients(χ2= 1375.408,3694.279,P = 0.000,0.000),the proportion of obesity(10.3%)was lower than that in female patients(χ2 = 2069.637,P = 0.000),the differences were statistically significant(P < 0.05);Compared with female patients,the proportion of smoking(76.9%)and drinking(76.9%)in male patients was higher than that in female patients(χ2 = 85.642,29.999,P = 0.000,0.000),the proportion of atrial fibrillation(76.9%)was lower than that in female patients(χ2 = 4.921,P =0.027),the differences were statistically significant(P < 0.05).3.The difference of influencing factors in different age groupsCompared with the elderly group,the proportion of smoking(42.4%)and drinking(23.7%)in the young and middle-aged group was higher(χ2=6.341、9.055,P=0.012 、 0.011),the proportion of hypertension(54.8%),coronary heart disease(9.6%)and carotid plaque(57.6%)was lower(χ2=6.391、9.011、12.711,P=0.041、0.011、0.002),the differences were statistically significant(P < 0.05).4.Correlation of influencing factors of cerebral infarctionHypertension,coronary heart disease,drinking and carotid plaque were closely related to the occurrence of cerebral infarction in young and middle-aged people(OR=0.436、1.518 、2.162、1.931,P=0.001、0.044、0.013、0.002).Conclusions1.The proportion of TOAST classification of cerebral infarction in different age groups is different,but the proportion of LAA is the highest.2.Smoking and drinking are important influencing factors for young and middle-aged patients,while hypertension,coronary heart disease,atrial fibrillation and carotid plaque are important influencing factors for elderly patients with cerebral infarction;The proportion of smoking and drinking in male population was higher than that in female population.3.Hypertension,coronary heart disease,drinking and carotid plaque are closely related to the occurrence of cerebral infarction in young and middle-aged people.