An analysis of risk factors and their prognostic effects on Chinese women's outcomes after ischemic stroke / 中华内科杂志

ABSTRACT

Objective To explore the risk factors and their prognostic value in Chinese female patients with ischemic stroke.Methods A total of 4 442 female patients with ischemic stroke were enrolled in the study from the Chinese National Stroke Registry System.According to the modified Rankin Scale (mRS) score,patients were divided into the group A (with good outcomes,mRS =0-2) and the group B (with bad outcomes,mRS =3-6),with the follow-up for 12 months.The risk factors were collected at month 3 and month 12,including age,family history,body mass index (BMI),hypertension,diabetes mellitus (DM),hyperlipidemia,atrial fibrillation (AF),coronary heart disease (CHD),smoking and moderate or heavy alcohol intake.The multivariate logistic regression was performed to determine the prognostic value of those risk factors.Results Patients in the group B were older than those in the group A [month 3:(71.3 ± 11.4) years oldvs (65.5±11.8) years old and month 12:(71.9±11.3) years old vs (65.1 ±11.6)years old,with both P ＜0.001].Patients in the group B were found to have higher ratio of BMI ＜25 kg/m2(66.3％ vs 62.0％,P =0.006;66.6％ vs 61.8％,P =0.002) and more likely to have the history of DM (27.0％ vs 23.3％,26.6％ vs 23.6％,respectively; both P ＜ 0.05),A F (18.0％ vs 6.2％,17.9％ vs 6.3％,respectively; both P ＜0.001) and CHD (21.4％ vs 14.4％,21.8％ vs 14.2％,respectively; both P ＜ 0.001) than those in the group A.The multivariate logistic regression analysis showed that women's age (OR =1.04,1.05,95％ CI 1.03-1.05,1.04-1.06,respectively),the histories of DM (both OR =1.35,95％ CI 1.15-1.58,respectively) and AF (OR =2.91,2.84,95％ CI 2.33-3.64,2.27-3.56,respectively) were significantly associated with the bad outcomes at month 3 and month 12.The history of CHD was associated with the bad outcomes at month 12 (OR =1.20,95％ CI 1.00-1.43),while the history of hyperlipidemia might improve the outcome at month 12 (OR =0.75,95％ CI 0.60-0.94).Conclusions The risk factors may have different prognostic value in female patients with ischemic stroke.The diagnosis and treatment for DM,AF and CHD may be helpful to improve the prognosis in Chinese female patients with ischemic stroke.