Secondary Prevention Of Outpatients With Ischemic Stroke At Department Of Neurology In Shanxi Province: A Follow-up Study

Objective:To assess the execution status of secondary prevention in outpatients with ischemic stroke after 5 years of follow- up.Methods:We have followed up the outpatients of five hospitals who participated in ROOTS project between Jul 2010 and Dec 2010 and patient’s general condition,drug usage,disease evolution,risk factor controlling end points,and so on,were collected.X2 test, multivariate logistic regression analysis and other statistical methods were used in this retrospective cohort study to assess the status of secondary prevention in outpatients with ischemic stroke.Results:There were 292 patients in total,after 5 years of follow-up, 25 individuals were lost to follow-up(13 were died, 7 refused and 5 changed phone numbers) and the rate is8.68%,and 267 subjects were included.Thirty-three patients suffered recurrent ischemic stroke,4 with myocardial infarction or angina pectoris and 1 with intracerebral hemorrhage.Thirty-four subjects(12.73%)with poor outcomes(mRS≥3).The use of antiplatelet drugs and statins are 68.91% and 21.72% respectively.The drug use-rate declined over time(P<0.05).The use of antihypertensive drugs is 88.89%.The drug use-rate increased over time(P<0.05).Compared with 5 years ago,the main reason for drug withdrawal was that patients thought they recovered better or the drugs were ineffective(P<0.05).Among the modifiablefactors,reviewed and with hypertension had an influence on the uses of the two drugs(P<0.05),while age and sex had no significant influence.There were 36 patients(12.32%) with atrial fibrillation and myocardial infarction,but only 6 patients used warfarin,then had followed up 2 patients used the drug.Smokers were less than 5 years ago,and the percentage of normal BMI were more than before(P<0.05).The use of statins and reviewed had significant influence between IS recurrence group and non(P<0.05).Fluid therapy can not decrease the recurrence of IS significantly.Conclusion:Although the IS secondary prevention had been better than before in our province significantly.The execution status of secondary prevention in outpatients with ischemic stroke is always far away from guidelines, and much need to be done in secondary prevention.