Analysis Of Risk Factors For Recurrence Of Non-disabling Ischemic Stroke Within 1 Year

Objective : Investigate the risk factors for recurrence in patients with acute non-disabling ischemic stroke within 1 year in this region,in order to provide more effective secondary prevention strategies for patients.Methods : Data were obtained from the neurology department of the Affiliated Hospital of Hebei University of Engineering from January 2017 to December 2017.This study assessed patients who were admitted to hospital in the first 7 days following symptom onset and diagnosed with non-disabling ischemic stroke(defined as NIHSS score ?3).Collecting baseline information of patients',including gender,age,previous history,smoking history,NIHSS score after admission and laboratory examinations.Patients were followed up for frequencies of recurrent stroke,secondary preventive therapy strategies and reasons for medications withdrawal within 1 year after discharge.The patients were divided to the group of patients with 1-year stroke recurrence and without stroke recurrence.Univariate analysis was used to compare baseline characteristics in patients between two groups.A multivariate logistic regression model with stepwise variable selection was employed to analyze risk factors releted to 1-year stroke recurrence.Results:1.264 patients with non-disabling ischemic stroke were enrolled,of whom171(64.77%)were male and 93(35.23%)were female,with an mean age of(63.52±8.70)years;The 3-month and 1-year recurrence rate were 5.3% and10.6%2..Results from the univariate analysis showed that,compared with the group without stroke recurrence,the group of patients with 1-year stroke recurrence significantly had a higher age(t = 2.683,P = 0.008),had a larger percentage of individuals with a history of hypertension(?2=4.636,P=0.031),diabetes(?2=7.591,P=0.006),atrial fibrillation(P=0.018),smoking(?2=4.060,P=0.044).The difference was statistically significant(P<0.05).3.Multivariate logistic regression analysis showed that age(OR=0.908,95%CI 0.853-0.966,P=0.002),history of hypertension(OR=0.118,95%CI 0.029-0.480,P=0.003),atrial fibrillation(OR=0.057,95%CI 0.013-0.252,P<0.01)were independent risk factors of 1-year stroke recurrence.4.The proportions of patients receiving antiplatelet agents,antihypertensive agents,statins,hypoglycemicagents declined from 91.3%?90.5%?88.3%?86.4% at discharge to 59.1%?54.2%?48.2%?40.7% at 1 year.5.The reasons for medications withdrawal were that: patients thought they were recovered(41%);occuring side effects of medications(11%);worrying about side effects(23%);economic reasons(9%);others(16%).Conclusions:Patients with non-disabling ischemic stroke in this region have a higher risk of recurrence within 1 year after discharge,and the recurrence rate is the highest in the first 3 months.The compliance of secondary prevention medications in patients with non-disabling ischemic stroke in this region showed a declining trend within 1 year after discharge,which was mainly related to medications withdrawal after patients' consciously rehabilitation.The high recurrence rate of patients with non-disabling ischemic stroke in this region may be related to the failure of early intervention,poor adherence to secondary preventive therapy strategies and failure to adhere to antiplatelet agent.Age,hypertension,diabetes,atrial fibrillation,and smoking history were risk factors for recurrence within 1 year.