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Time to recurrence after first-ever ischaemic stroke within 3 years and its risk factors in Chinese population: a
Jing Zhang1, Ping Zhu1,2, Bingqing Liu1
1Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
Insights
Recurrent ischemic stroke occurred in 115 of 641 patients within 3 years. Modified Rankin Scale score and drug adherence significantly impact stroke recurrence time.
Area of Science:
- Neurology
- Public Health
- Epidemiology
Background:
- Ischemic stroke recurrence poses a significant health burden.
- Understanding the timing and risk factors for recurrence is crucial for patient management.
Purpose of the Study:
- To estimate the time to first recurrent ischemic stroke within 3 years post-discharge.
- To identify key risk factors influencing stroke recurrence time.
Main Methods:
- Prospective cohort study involving 641 patients hospitalized for first-ever ischemic stroke.
- Restricted Mean Survival Time (RMST) analysis was used to estimate recurrence time.
- Data on sociodemographics and risk factors were collected via questionnaires.
Main Results:
- The cumulative risk of stroke recurrence reached 20.07% at 3 years.
- Higher Modified Rankin Scale (mRS) scores and lower drug adherence were associated with significant time loss to recurrence.
- Age did not show a statistically significant impact on recurrence time.
Conclusions:
- Stroke recurrence timing varies significantly among patients.
- Functional outcome (mRS) and medication adherence are critical factors influencing recurrent ischemic stroke.
Objective:
This study aimed to estimate the time of recurrent ischaemic stroke events among the first 3 years of follow-up after hospitalisation discharge.
Study Design:
A prospective cohort study.
Setting:
The research was conducted in the Department of Neurology at a tertiary hospital, Chengdu of China, from January 2010 to June 2016.
Outcome Measures:
We estimated the restricted mean survival time (RMST) of ischaemic stroke recurrence for the first 3 years after discharge. Basic sociodemographic characteristics and major potential risk factors for recurrence were collected using a semistructured questionnaire. Regression analysis of RMST was used to identify risk factors of recurrent stroke.
Participants:
Patients hospitalised with first-ever ischaemic stroke were eligible for this study. Patients with severe cognitive impairment were excluded.
Results:
We included 641 surviving patients who were followed up for 3 years. Stroke recurrence occurred in 115 patients, including 16 patients who died of stroke recurrence. The cumulative risk of stroke recurrence rate was 11.51% (9.20%-14.35%) at 1 year, 16.76% (13.96%-20.05%) at 2 years and 20.07% (17.00%-23.61%) at 3 years. Modified Rankin Scale (mRS) score ≥3 thus resulted in the recurrence time loss, which was 0.22 months (p=0.008) at 6 months, 0.61 months (p=0.004) at 1 year, 1.49 months (p=0.007) at 2 years and 2.46 months (p=0.008) at 3 years. It is similar with the effects of drug adherence after stroke. The recurrence time of patients ≥75 years at 3 years was 2.02 months (p=0.220) less than that of those aged <55 years.
Conclusion:
In China, the time of first recurrence varies among different patients with ischaemic stroke. The mRS and the level of drug adherence after stroke are important risk factors of stroke recurrence.
