| Objective: Stroke is one of important diseases with high incidence, high mortality, high disable rate and high recurrence rate. To understand survival and recurrence conditions of stroke patients and analyze the factors associated with survival and recurrence, a seven years follow-up study was carried out. Method: From Nov. 1995 to Dec. 1996, 189 stroke patients were selected in Department of Neurology, the General Hospital, Tianjin Medical University. All cases were diagnosed according to cerebrovascular diagnostic criteria revised by Chinese Medical Association Second National Conference on Cerebrovascular diseases and identified by CT scan. All patients were attacked within 48 hours and had lived in Tianjin for more than 15 years. The cases were followed up in 3 months, 6 months, 3 years and 7 years since occurrence of the stroke. The data collected included the history of past illness, physical examination, laboratory examination, and survival conditions. The work of follow-up ended on Oct. 8th 2003. For the statistical analyses, Life-Table and Kaplan-Meier methods were used for survival description, and Log Rank test was used for the comparison of survivals. Cox regression was used as main statistical methods for prognostic factors analyses.Results: 1. At the end of follow-up, 82 patients were dead. Main causes of death were stroke and cardiovascular disease. The Survival rate was 80.58% in one year, 65.46% in three years and 57.46% in seven years. Of 189 patients,65 cases were recurrent when the follow-up was finished. The recurrent rate was 47.16% in seven years. 51 cases died of stroke recurrence in all.2. The main stroke survival factors with statistical significance include: age(RR=1.065 P<0.001), physical exercises before stroke(RR=0.308, P<0.001) , hypertension history (RR=1.785, P<0.05) and stroke history (RR=2.493, P<0.001) ; the factors associated with severity of illness such as patients' status of consciousness, nervous system symptom, brain injury condition, complications such as digestive tract hemorrhage and respiratory tract symptom; agnosia and anepia; laboratory examinations such as blood glucose level (RR=1.006, P<0.001) ; and the conditions when discharged from the hospital, rehabilitative treatment of post-discharge and recurrence are also statistically significant. Meanwhile, we also found that social-psychic factor such as rehabilitative confidence, repression, negative event, support from relatives and friends are related to prognosis of stroke.3. The main stroke recurrence factors with statistical significance include: age, physical exercises before stroke, cardiac disease history(RR=2.137, ,P<0.05 ) , the factors associated with severity of illness such asconsciousness when came to the hospital, positive pathologic reflex(RR=5.700, P<0.001) , brain injury condition such as area of brain impact(RR= 1.020, P<0.05) , cerebral ventricle extended, agnosia and anepia.Furthermore, discharge with physician order and social psychic factor werealso related to recurrence of stroke.Conclusion: Hypertension history, stroke history, cardiac disease history and brain injury condition and nervous system symptom were related to survival and recurrence of stroke. The patients persisting physical exercises before stroke had the best prognosis and lest recurrence. Social psychic factor,especially depression after stroke may be related to the recurrence. Some social factors such as social assistance and support from relatives and friends also have positive effect on the reduction of possibility of recurrence. |
PDF Full Text Request