2000-2020年中风复发和复发后死亡率趋势中的性别差异:科普斯克里斯蒂的基于人口的大脑发作监测项目
Chen Chen1, Mathew J Reeves2, Kevin He3
1Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
Annals of neurology
|May 17, 2024
概括
重复中风的风险显著下降,特别是在女性中,这表明二次中风预防得到了改善. 然而,中风后的死亡率仍然很高,需要继续进行干预,以便在中风幸存者中获得更好的结果.
科学领域:
- 神经学 神经学
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 脑卒中复发和死亡率是严重的公共卫生问题.
- 了解中风结果的性别特异性趋势对于有针对性的预防和治疗策略至关重要.
- 科普斯克里斯蒂大脑攻击监测 (BASIC) 项目提供了关于缺血性中风 (IS) 的宝贵基于人口的数据.
研究的目的:
- 分析21年内缺血性中风复发的性别特异性趋势.
- 调查中风后死亡率的性别特异性趋势.
- 为了确定性差异的变化,无论是复发和死亡率随着时间的推移.
主要方法:
- 利用了德克萨斯州南部 (2000-2020年) 基于人口的BASIC项目的数据.
- 包括有史以来第一次缺血性中风的患者,随访复发和全因死亡率.
- 采用多变量回归模型与日历年和性别的相互作用项.
主要成果:
- 在5年内,10.8%的患者出现了复发,而47.7%的患者在复发后面临死亡.
- 五年复发风险在女性和男性中显著下降,女性的下降幅度更大.
- 虽然女性最初的复发后死亡率较低,但随着时间的推移,风险增加,缩小了性别差距.
结论:
- 回复性中风率的下降表明,二次预防工作取得了成功,特别是对女性来说.
- 复发后的高死亡率仍然存在,这突显了改善干预措施的必要性,以改善复发性脑血管事件后的预后.
- 需要进一步的研究来解决中风幸存者的持续死亡挑战.
更多相关视频
09:11Performing Permanent Distal Middle Cerebral with Common Carotid Artery Occlusion in Aged Rats to Study Cortical Ischemia with Sustained Disability
Published on: February 23, 2016
21.6K
04:38A Middle Cerebral Artery Occlusion Technique for Inducing Post-stroke Depression in Rats
Published on: May 22, 2019
10.3K
相关概念视频
Stroke: Introduction and Types
55
A stroke is an acute neurological event caused by the sudden disruption of cerebral blood flow, leading to rapid loss of neuronal function. Neurons depend on continuous oxygen and glucose supply, so even brief interruptions can cause irreversible injury within minutes. Strokes are classified into ischemic and hemorrhagic types.Ischemic StrokeIschemic strokes are most common and occur due to arterial occlusion, depriving brain tissue of oxygen and nutrients. This leads to energy failure, ionic...
55
Ischemic Stroke l: Introduction
44
Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
44
Ischemic Stroke ll: Pathophysiology
54
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
54
Hemorrhagic Stroke l: Introduction
20
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
20
Hemorrhagic Stroke ll: Pathophysiology
30
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
30
Transient Ischemic Attack l: Introduction
18
A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...
18
