Retrospective Cohort Study On Risk Factors Of Hemorrhagic Stroke In Hainan Hypertensive Population Over 40 Years Old

Objective To explore the risk factors and predictors of hemorrhagic stroke and to provide basis for targeted prevention and treatment of hemorrhagic stroke by a retrospective cohort study.Methods In this study,people were selected patients with hypertension(HTN),diabetes mellitus(DM)and hyperlipidemia(HLP)who were hospitalized in The Second Affiliated Hospital of Hainan Medical university from the January 1,2013 to June 30,2020.The patients were divided into observation group(HTN+HLP+DM group,group A)and control group[HTN+HLP group(B),HTN+DM group(C),HTN group(D)].The method of follow-up is followed up by electronic medical record system and telephone.Demographic,clinical symptoms,medical history,course of disease,and laboratory tests were collected after enrollment to compare the differences between groups and their relationship with the incidence density and cumulative incidence of hemorrhagic stroke.Univariate and multivariate Cox regression analysis were used to evaluate the risk factors of hemorrhagic stroke and screen the indicators with predictive value..Results 1.2850 patients were enrolled and there were 1555 males and 1295 females.The median age at baseline was 69(61,77)years old.The mean follow-up was 1625(999,2124)days,with 83 cases of hemorrhagic stroke occurred.There were 1054cases in the observation group and 1796 cases in the control group,with 35 cases and 48 cases of hemorrhagic stroke respectively.There was no difference in risk between the two groups after excluding lost follow-up cases(?~2=0.875,P=0.350).Compared with the control group,the RR,AR and AR%of hemorrhagic stroke in observation group were 1.237,150.73per 100,000 person-years and0.23.7%,respectively.2.Multivariate Cox regression of the total population,showed that male,history of CI,history of CHD,and decrease in lymphocyte count(LYM,≤1.37×10~9/L、1.38 to 1.77×10~9/L)increased risk of hemorrhagic stroke,and the incidence of hemorrhagic stroke in the observation population was 1.581 times higher than that in the control population(P<0.05).Conclusion HTN,HLP and DM were exposed together,male,CI history,CHD history and LYM decreased(≤1.77×10~9/L)may be risk factors for hemorrhagic stroke,which were used as the combined predictors of hemorrhagic stroke.Controlling blood pressure,glucose and lipids is an important means to prevent hemorrhagic stroke.