The evaluation of cognitive impairment and analysis of risk factors for stroke recurrence in elderly patients with minor ischemic stroke / 中华老年医学杂志

ABSTRACT

Objective To evaluate the cognitive impairment in elderly patients with minor ischemic stroke and to analyze risk factors for stroke recurrence.Methods This was a retrospective case-control study.Ninety-five elderly patients with acute ischemic stroke hospitalized in the neurology department of Second People's Hospital of Liaocheng were enrolled from January 2016 to January 2017.Based on the National Institutes of Health Stroke Scale(NIHSS),all cases were divided into the minor stroke group(NIHSS score≤3,n=62)and the medium-severe stroke group(NI HSS score＞ 3,n =33).After 12-month follow-up,the NIHSS,modified Rankin scale(mRS)and Montreal cognitive assessment (MoCA)were used to evaluate the study subjects.Results Of the 95 patients,there were 62 males(65.3％)and 33 females(34.7％),with age of(68.3 ± 6.7) years.No significant differences were found in baseline characteristics of age,male ratio,subtypes and history between two groups(all P＞0.05).But,the treatment rate of intravenous thrombolysis was lower in minor stroke group than in medium-severe stroke group [6.5 ％ (4 cases) vs.42.4 ％ (14 cases) (P ＜ 0.01)].The scores of NIHSS[(1.0±0.5)vs.(3.2± 1.1),P＜0.01],mRS[(1.6±0.7)vs.(2.4± 1.1),P＜0.01] were lower in the minor stroke group than in the medium-severe group.After a mean follow-up of(12.6± 1.9)months,the rate of cognitive impairment was comparable between the two groups(P ＞0.05),while the rate of post stroke depression had a significant difference between two groups(P＜0.05).Furthermore,there was lower rate of mortality and stroke recurrence in the minor stroke group than in the medium-severe group(0.0％ or 0/62 vs.30.3％ or 10/33,and 21.0％ or 13/62 vs.42.4％ or 14/33,P＜0.05).Cox proportional hazard model showed that baseline NIHSS score,diabetes and stroke history were the risk factors for stroke recurrence in patients with minor stroke(P＜0.05).Conclusions The treatment rate of intravenous thrombolysis with rt-PA,mortality rate and stroke recurrence rate are lower in patients with minor stroke than in patients with medium-severe stroke,while the incidence of post stroke cognitive impairment is high.High score of baseline NIHSS,diabetes and stroke history are risk factors for stroke recurrence in elderly patients with minor stroke.