脑卒中复发的长期风险:基于南伦敦脑卒中登记册的竞争性风险分析
Li Zhang1,2, Marc Delord1, Iain Marshall1
1School of Life Course and Population Sciences King's College London London United Kingdom.
Journal of the American Heart Association
|March 10, 2026
概括
在第一次中风后,中风复发风险很大. 种族,高血压和先前的TIA等因素增加了风险,需要有针对性的预防策略. 准确的风险评估需要考虑竞争的死亡风险.
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:
- 以前的中风复发研究往往忽视了竞争的死亡风险,可能会扭曲结果.
- 这项研究通过估计首次中风患者中风复发率和相关因素来解决这一差距.
研究的目的:
- 准确估计第一次中风后中风复发的风险.
- 确定与中风复发相关的人口和临床因素.
- 在风险估计中考虑死亡的竞争风险.
主要方法:
- 利用了来自南伦敦中风登记册 (SLSR) 的数据,涵盖1995-2019年.
- 采用累积发病率函数和细灰竞争风险模型.
- 将死亡作为一个竞争事件来分析中风复发.
主要成果:
- 包括5509名患者;12.3%的患者在34,874个人年中经历了中风复发.
- 累积复发风险在25年达到15.2%,在缺血性中风 (10年风险12.7%) 后高于出血性中风 (10年风险11.1%).
- 确定了缺血性中风复发的风险因素:黑人种族,高血压,先前的TIA和非医院入院. 糖尿病是出血性中风复发的危险因素.
结论:
- 对于缺血性和出血性中风类型,中风复发风险是相当大的.
- 竞争性风险分析提供了更准确的复发估计.
- 人口和临床因素对于制定有效的中风复发预防策略至关重要.
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