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Mortality and recurrence of vascular disease among stroke patients treated with combined TCM therapy
Xiao-feng Zhao1, Shi-jun Su, Guo Yun
1Institute of Acupuncture and Moxibustion, the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, China.
Insights
Advanced age and a history of previous stroke are key predictors of mortality and poor outcomes in stroke patients treated with Traditional Chinese Medicine (TCM). Carotid arterial lesions and diabetes history also influence vascular event recurrence.
Area of Science:
- Neurology
- Cardiology
- Integrative Medicine
Background:
- Stroke is a leading cause of long-term disability and mortality worldwide.
- Traditional Chinese Medicine (TCM) offers a complementary approach to stroke management.
- Understanding long-term outcomes and predictors is crucial for optimizing patient care.
Purpose of the Study:
- To evaluate the long-term outcomes of stroke patients receiving combined TCM therapy.
- To identify predictors of mortality, recurrent vascular events, and overall poor outcomes.
Main Methods:
- Retrospective hospital-based cohort study.
- Inclusion of 405 stroke patients admitted to a TCM hospital between 2008 and 2009.
- One-year follow-up to assess vascular event recurrence, mortality, and combined poor outcomes.
Main Results:
- 1-year mortality rate was 11.11%, with 23.70% experiencing recurrent vascular events.
- Poor outcomes (recurrence or death) affected 30.86% of patients.
- Predictors for death included advanced age and previous stroke; recurrence was linked to carotid lesions, diabetes, and prior stroke.
Conclusions:
- Advanced age, prior stroke history, carotid arterial lesions, and diabetes history significantly impact stroke outcomes.
- These findings are vital for future stroke research in TCM settings.
- TCM may play a role in managing stroke, with specific factors influencing different adverse events.
Objective:
To confirm the long-term outcomes of stroke patients and determine predicting factors for death, recurrence of vascular events and poor outcome (either recurrence or death) after the use of combined TCM therapy.
Methods:
This was a retrospective hospital-based cohort study and was performed in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine in Tianjin. All subjects with stroke consecutively admitted to an inpatient ward of the Acupuncture Department from January 1, 2008, to December 31, 2008 were retrospectively followed through one year. The main outcomes were either a recurrence of vascular events, mortality or both. Risk factors were recorded from medical records. Multivariate regression models were used to analyze predictors. The following independent variables were used: age, gender, hypertension, ischemic heart disease, atrial fibrillation, diabetes mellitus, carotid arterial lesions and history of stroke.
Results:
Four-hundred and five patients were included. The 1-year mortality rate was 11.11%. 23.70% of the patients had a recurrent vascular event, and 30.86% suffered a poor outcome. Multiple logistic regression analysis found that previous stroke, and advanced age were predictors of death within one year, Recurrence of vascular events was associated with carotid arterial lesions, history of diabetes and previous stroke. Long-term poor outcome was predicted by advanced age, history of diabetes, and previous stroke.
Conclusion:
Age, previous stroke, carotid arterial lesions and diabetes history seem to have different impacts on the three outcomes within one year. Our findings provide important data for planning future hospital register studies of stroke patients in TCM hospitals.