Risk factors affecting the 1-year outcomes of minor ischemic stroke: results from Xi’an stroke registry study of China[1]

Abstract Background: The incidences of stroke recurrence, disability, and all-cause death of patients with minor ischemic stroke (MIS) remain problematic. The aim of the present was to identify risk factors associated with adverse outcomes at 1-year after MIS in the Xi’an region of China. Methods: The cohort of this prospective cohort study included MIS patients aged 18–97 years with a National Institutes of Health Stroke Scale (NIHSS) score of ≤ 3 who were treated in any of four hospitals in Xi’an region of China between January and December 2015. The 1-year percentage of stroke recurrence, disability, and all-cause death were evaluated. Multivariate logistic regression analysis was performed to assess the association between the identified risk factors and clinical outcomes. Results: Among the 1,121 patients included for analysis, the percentage of stroke recurrence, disability, and all-cause death at 1 year after MIS were 3.4% (38/1121), 9.3% (104/1121), and 3.3% (37/1121), respectively. Multivariate logistic regression analysis identified age, current smoking, and pneumonia as independent risk factors for stroke recurrence. Age, pneumonia, and alkaline phosphatase were independent risk factors for all-cause death. Independent risk factors for disability were age, pneumonia, NIHSS score on admission, and leukocyte count. Conclusions: The 1-year outcomes of MIS is not optimistic in the Xi’an region of China, especially high percentage of disability. In this study, we found the risk factors affecting 1-year stroke recurrence, disability and, all-cause death which need further verification in the subsequent studies.

Download Full-text

Risk factors affecting the 1-year outcomes of minor ischemic stroke: results from Xi’an stroke registry study of China

10.21203/rs.3.rs-38303/v3 ◽

2020 ◽

Author(s):

Zhongzhong Liu ◽

Wenjuan Lin ◽

Qingli Lu ◽

Jing Wang ◽

Pei Liu ◽

...

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Stroke Recurrence ◽

Multivariate Logistic Regression ◽

Factors Affecting ◽

Nihss Score ◽

Minor Ischemic Stroke ◽

All Cause Mortality ◽

Independent Risk Factors

Abstract Background: The prevalence of stroke recurrence, disability, and all-cause mortality of patients with minor ischemic stroke (MIS) remains problematic. The aim of the present study was to identify risk factors associated with adverse outcomes at 1 year after MIS in the Xi’an region of China. Methods: This prospective cohort study included MIS patients above 18 years old with National Institutes of Health Stroke Scale (NIHSS) score ≤ 3 who were treated in any of four hospitals in Xi’an region of China between January and December 2015. The 1-year prevalence of stroke recurrence, disability, and all-cause mortality were evaluated, respectively. Multivariate logistic regression analysis was performed to assess the association between the identified risk factors and clinical outcomes. Results: In this study, 131(10.5%，131/1252) patients were lost to follow-up at 1 year. A total of 1,121 patients included for analysis, the prevalence of stroke recurrence, disability, and all-cause mortality at 1 year after MIS were 3.4% (38/1121), 9.3% (104/1121), and 3.3% (37/1121), respectively. Multivariate logistic regression analysis identified age, current smoking, and pneumonia as independent risk factors for stroke recurrence. Age, pneumonia, and alkaline phosphatase were independent risk factors for all-cause mortality. Independent risk factors for disability were age, pneumonia, NIHSS score on admission, and leukocyte count. Conclusions: The 1-year outcomes of MIS in Xi’an region of China were not optimistic, especially with a high prevalence of disability. The present study indicated that age and pneumonia were the common independent risk factors affecting the 1-year outcomes of MIS in Xi’an region of China.

Download Full-text

Risk factors affecting the 1-year outcomes of minor ischemic stroke: results from Xi’an stroke registry study of China

BMC Neurology ◽

10.1186/s12883-020-01954-3 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Zhongzhong Liu ◽

Wenjuan Lin ◽

Qingli Lu ◽

Jing Wang ◽

Pei Liu ◽

...

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Stroke Recurrence ◽

Multivariate Logistic Regression ◽

Factors Affecting ◽

Nihss Score ◽

Minor Ischemic Stroke ◽

All Cause Mortality ◽

Independent Risk Factors

Abstract Background The prevalence of stroke recurrence, disability, and all-cause mortality of patients with minor ischemic stroke (MIS) remains problematic. The aim of the present study was to identify risk factors associated with adverse outcomes at 1 year after MIS in the Xi’an region of China. Methods This prospective cohort study included MIS patients above 18 years old with National Institutes of Health Stroke Scale (NIHSS) score ≤ 3 who were treated in any of four hospitals in Xi’an region of China between January and December 2015. The 1-year prevalence of stroke recurrence, disability, and all-cause mortality were evaluated, respectively. Multivariate logistic regression analysis was performed to assess the association between the identified risk factors and clinical outcomes. Results In this study, 131(10.5%, 131/1252) patients were lost to follow-up at 1 year. A total of 1121 patients were included for analysis, the prevalence of stroke recurrence, disability, and all-cause mortality at 1 year after MIS were 3.4% (38/1121), 9.3% (104/1121), and 3.3% (37/1121), respectively. Multivariate logistic regression analysis identified age, current smoking, and pneumonia as independent risk factors for stroke recurrence. Age, pneumonia, and alkaline phosphatase were independent risk factors for all-cause mortality. Independent risk factors for disability were age, pneumonia, NIHSS score on admission, and leukocyte count. Conclusions The 1-year outcomes of MIS in Xi’an region of China were not optimistic, especially with a high prevalence of disability. The present study indicated that age and pneumonia were the common independent risk factors affecting the 1-year outcomes of MIS in Xi’an region of China.

Download Full-text

Risk factors affecting the 1-year outcomes of minor ischemic stroke: results from Xi’an stroke registry study of China

10.21203/rs.3.rs-38303/v4 ◽

2020 ◽

Author(s):

Zhongzhong Liu ◽

Wenjuan Lin ◽

Qingli Lu ◽

Jing Wang ◽

Pei Liu ◽

...

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Stroke Recurrence ◽

Multivariate Logistic Regression ◽

Factors Affecting ◽

Nihss Score ◽

Minor Ischemic Stroke ◽

All Cause Mortality ◽

Independent Risk Factors

Abstract Background: The prevalence of stroke recurrence, disability, and all-cause mortality of patients with minor ischemic stroke (MIS) remains problematic. The aim of the present study was to identify risk factors associated with adverse outcomes at 1 year after MIS in the Xi’an region of China. Methods: This prospective cohort study included MIS patients above 18 years old with National Institutes of Health Stroke Scale (NIHSS) score ≤ 3 who were treated in any of four hospitals in Xi’an region of China between January and December 2015. The 1-year prevalence of stroke recurrence, disability, and all-cause mortality were evaluated, respectively. Multivariate logistic regression analysis was performed to assess the association between the identified risk factors and clinical outcomes. Results: In this study, 131(10.5%，131/1252) patients were lost to follow-up at 1 year. A total of 1,121 patients were included for analysis, the prevalence of stroke recurrence, disability, and all-cause mortality at 1 year after MIS were 3.4% (38/1121), 9.3% (104/1121), and 3.3% (37/1121), respectively. Multivariate logistic regression analysis identified age, current smoking, and pneumonia as independent risk factors for stroke recurrence. Age, pneumonia, and alkaline phosphatase were independent risk factors for all-cause mortality. Independent risk factors for disability were age, pneumonia, NIHSS score on admission, and leukocyte count. Conclusions: The 1-year outcomes of MIS in Xi’an region of China were not optimistic，especially with a high prevalence of disability. The present study indicated that age and pneumonia were the common independent risk factors affecting the 1-year outcomes of MIS in Xi’an region of China.

Download Full-text

Risk factors Affecting the 1-year Outcomes of Minor Ischemic Stroke: Results from Xi’an Stroke Registry Study of China

10.21203/rs.3.rs-38303/v1 ◽

2020 ◽

Author(s):

Zhongzhong Liu ◽

Wenjuan Lin ◽

Qingli Lu ◽

Jing Wang ◽

Pei Liu ◽

...

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Clinical Outcomes ◽

Multivariate Logistic Regression Analysis ◽

Stroke Recurrence ◽

Multivariate Logistic Regression ◽

Nihss Score ◽

Minor Ischemic Stroke ◽

All Cause Mortality ◽

Independent Risk Factors

Abstract Background: The incidences of stroke recurrence, disability, and all-cause mortality of patients with minor ischemic stroke (MIS) remain problematic. The aim of the present was to identify risk factors associated with adverse outcomes at 1-year after MIS in the Xi’an region of China. Methods: The cohort of this prospective cohort study included MIS patients aged 18–97 years with a National Institutes of Health Stroke Scale (NIHSS) score of ≤ 3 who were treated in any of four hospitals in Xi’an region of China between January and December 2015. The 1-year rates of stroke recurrence, disability, and all-cause mortality were evaluated. Multivariate logistic regression analysis was performed to assess the association between the identified risk factors and clinical outcomes. Results: Among the 1,121 patients included for analysis, the rates of stroke recurrence, disability, and all-cause mortality at 1 year after MIS were 3.4% (38/1121), 9.3% (104/1121), and 3.3% (37/1121), respectively. Multivariate logistic regression analysis identified age, current smoking, and pneumonia as independent risk factors for stroke recurrence. Age, pneumonia, and alkaline phosphatase were independent risk factors for all-cause mortality. Independent risk factors for disability were age, pneumonia, NIHSS score on admission, and leukocyte count. Conclusions: The 1-year outcomes of MIS is not optimistic in the Xi’an region of China. Early identification of risk factors for poor clinical outcomes, attention to high risk populations, and targeted interventions contribute to reducing the risk for poor clinical outcomes of patients at 1 year after onset of MIS.

Download Full-text

Decreased eGFR Is Associated With Ischemic Stroke in Patients With Dilated Cardiomyopathy

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029619866909 ◽

2019 ◽

Vol 25 ◽

pp. 107602961986690 ◽

Cited By ~ 1

Author(s):

Yuqing Deng ◽

Zhiqing Chen ◽

Lili Hu ◽

Zhenyan Xu ◽

Jinzhu Hu ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Ischemic Stroke ◽

Dilated Cardiomyopathy ◽

Logistic Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Analysis Model ◽

Multivariate Logistic Regression ◽

Increased Risk

Dilated cardiomyopathy (DCM) is increasingly indicated as a cause of cardioembolic syndrome, in particular, cardioembolic ischemia stroke. However, the potential risk factors for stroke among DCM patients remain under investigated. DCM patients hospitalized from June 2011 to June 2016 were included. The cases were defined as the group of DCM patients with stroke compared with those without stroke. Clinical characteristic data were collected and compared between the two groups including demographic data, complicated diseases, echocardiography index, and laboratory parameters and estimated glomerular filtration rate (eGFR). A multivariate logistic regression analysis model adjusted by sex and age was used to explore the related risk factors for stroke in DCM patients. A total of 779 hospitalized patients with DCM were included. Of these, 55 (7.1%) had experienced a stroke. Significantly lower eGFR levels (68.03 ± 26.22 vs 79.88 ± 24.25 mL/min/1.73 m2, P = .001) and larger left atrial diameters (45.32 ± 7.79 vs 43.25 ± 7.11 mm, P = .04) were found in the group of patients having DCM with stroke compared to those without stroke. When the eGFR was categorized as eGFR >60, 30<eGFR≤ 60 and eGFR ≤ 30, there were more patients with 30<eGFR≤ 60 (30.9% vs 17.7%) and eGFR≤ 30 (9.1% vs 3.3%) in the ischemic stroke group ( P = 0.003). A multivariate logistic regression analysis model adjusted by sex and age showed that 30 <eGFR≤60 (odds ratio [OR]: 2.07, 95% confidence interval [CI]: [1.05-4.07], P = .035) and eGFR≤30 (OR: 4.04, 95% CI: [1.41-11.62], P = .009) were statistically associated with ischemic stroke in patients with DCM. It is concluded that decreased eGFR is significantly associated with an increased risk of ischemic stroke in patients with DCM.

Download Full-text

Risk factors for periprocedural ischemic stroke following endovascular treatment of intracranial aneurysms

Chinese Neurosurgical Journal ◽

10.1186/s41016-021-00255-z ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Yisen Zhang ◽

Chao Wang ◽

Zhongbin Tian ◽

Wei Zhu ◽

Wenqiang Li ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Ischemic Stroke ◽

Treatment Modality ◽

Intracranial Aneurysms ◽

Univariate Analysis ◽

Multivariate Logistic Regression Analysis ◽

Flow Diverter ◽

Multivariate Logistic Regression

Abstract Background The aim of this study was to comprehensively evaluate the risk factors of periprocedural ischemic stroke associated with endovascular treatment of intracranial aneurysms using a real-world database. Methods From August 2016 to March 2017, 167 patients were enrolled. Univariate analysis and multivariate logistic regression analysis were used to examine the risk factors for periprocedural ischemic stroke. Results Among the 167 cases, periprocedural ischemic stroke occurred in 20 cases (11.98%). After univariate analysis, the ischemic group had a higher proportion of large (≥ 10 mm) aneurysms than the control group (45.0% vs. 23.1%, p = 0.036). The incidence of periprocedural ischemic stroke was higher in cases treated by flow diverter (21.6%) or stent-assisted coiling (11.8%) than in cases treated by coiling only (2.7%), and the differences were statistically significant (p = 0.043). After multivariate logistic regression analysis, treatment modality was the independent risk factor for periprocedural ischemic stroke. Compared with the coiling-only procedure, flow diverter therapy was associated with a significantly higher rate of periprocedural ischemic stroke (OR 9.931; 95% CI 1.174–84.038; p = 0.035). Conclusions Aneurysm size and treatment modality were associated with periprocedural ischemic stroke. Larger aneurysms were associated with increased risk of periprocedural ischemic stroke. Flow diverter therapy was associated with significantly more periprocedural ischemic stroke than the coiling procedure alone.

Download Full-text

Nomogram for Predicting Persistent Organ Failure with Acute Pancreatitis in Pregnancy

10.21203/rs.3.rs-1223472/v1 ◽

2022 ◽

Author(s):

Chengcheng Sheng ◽

Zongxu Xu ◽

Jun Wang

Keyword(s):

Risk Factors ◽

Acute Pancreatitis ◽

Logistic Regression ◽

Regression Analysis ◽

Organ Failure ◽

Multivariate Logistic Regression Analysis ◽

Concordance Index ◽

Multivariate Logistic Regression ◽

Independent Risk Factors ◽

In Pregnancy

Abstract Background: Acute pancreatitis in pregnancy (APIP) with persistent organ failure (POF) poses a high risk of death for mother and fetus. This study sought to create a nomogram model for early prediction of POF with APIP patients.Methods: We conducted a cross-sectional study on APIP patients with organ failure (OF) between January 2012 and March 2021 in a university hospital. 131 patients were collected. Their clinical courses and pregnancy outcomes were obtained. Risk factors for POF were identified by univariate and multivariate logistic regression analysis. Prediction models with POF were built and nomogram was plotted. The performance of the nomogram was evaluated by using a bootstrapped-concordance index and calibration plots.Results: Hypertriglyceridemia was the most common etiology in this group of APIP patients, which accounted for 50% of transient organ failure (TOF) and 72.3% of POF. All in-hospital maternal death was in the POF group (P<0.05), which also had a significantly higher perinatal mortality rate than the TOF group (P<0.05). Univariate and multivariate logistic regression analysis determined that lactate dehydrogenase, triglycerides, serum creatinine, and procalcitonin were independent risk factors for predicting POF in APIP. A nomogram for POF was created by using the four indicators. The area under the curve was 0.875 (95% confidence interval 0.80–0.95). The nomogram had a bootstrapped-concordance index of 0.85 and was well-calibrated.Conclusions: Hypertriglyceridemia was the leading cause of organ failure-related APIP. Lactate dehydrogenase, triglycerides, serum creatinine, and procalcitonin were the independent risk factors of POF in APIP. Our nomogram model showed an effective prediction of POF with the four indicators in APIP patients.

Download Full-text

Abstract TP176: Risk Factors and Clinical Significances of the Quantitative CTA Vascular Calcification in Ischemic Stroke Patients

Stroke ◽

10.1161/str.51.suppl_1.tp176 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Takashi Shimoyama ◽

Sibaji Gaj ◽

Kunio Nakamura ◽

Shivakrishna Kovi ◽

Ken Uchino

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Ischemic Stroke ◽

Vascular Calcification ◽

Logistic Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Stroke Patients ◽

Age Category

Background and Purpose: Intracranial arterial calcification is a marker of atherosclerosis burden in the general population. The aim of the study is to investigate risk factor profiles of vascular calcification in ischemic stroke patients. Methods: We identified ischemic stroke patients who underwent complete CTA from a prospective single-hospital stroke registry in 2018. Automatic artery and calcification segmentation method measured calcification volumes in the intracranial, extracranial, and aortic arteries using deep-learning U-net model and region-grow algorithms. Severe vascular calcification was defined as patients in the upper quartile calcification volume. The prevalence of severe vascular calcification and mean calcification volume were investigated by age category (<60 years, 60-70 years, 70-80 years, 80 years ≥). The relation between each potential risk factors and severe vascular calcification was assessed using the multivariate logistic regression analysis adjusted for age, sex, NIHSS score, and TOAST stroke subtypes. Results: Of the 558 consecutive acute ischemic stroke patients, 388 patients (212 males; mean age 66.6±14.2 years) met inclusion and with quantitative CTA calcification. The prevalence of severe vascular calcification (CTA calcification volume> 812 mm 3 ) increased with increasing age category (<60 years: 6.8% (7/103), 60-70 years: 15.7% (18/115), 70-80 years: 39.6% (38/105), 80 years ≥: 45.9% (34/74), P<0.001 for χ 2 test). Over age 80 years subsets had significantly higher mean calcification volume with 1213 mm 3 than other age category (<60 years: 225 mm 3 , P<0.001; 60-70 years: 462 mm 3 , P<0.001; 70-79 years: 817 mm 3 , P=0.020 for t-test). In the multivariate logistic regression analysis, age (OR 1.096, 95% CI 1.066-1.128, P<0.001), smoking (OR 3.430, 95% CI 1.833-6.419, P<0.001), and large artery atherosclerosis (LAA) (OR 4.260, 95% CI 1.963-9.247, P<0.001) were independently associated with severe vascular calcification. Conclusion: In the quantitative CTA analysis of calcification volume, older age and smoking were high risk for severe atherosclerotic calcium burden in ischemic stroke patients. Moreover, severe vascular calcification may differentiate LAA from other stroke etiology.

Download Full-text

Risk Factors for Maternal and Fetal Mortality in Acute Fatty Liver of Pregnancy and New Predictive Models

Frontiers in Medicine ◽

10.3389/fmed.2021.719906 ◽

2021 ◽

Vol 8 ◽

Author(s):

Zhaoli Meng ◽

Wei Fang ◽

Mei Meng ◽

Jicheng Zhang ◽

Qizhi Wang ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Maternal Mortality ◽

Predictive Models ◽

Multivariate Logistic Regression Analysis ◽

Fetal Mortality ◽

Multivariate Logistic Regression ◽

Acute Fatty Liver ◽

Independent Risk Factors

Acute fatty liver of pregnancy (AFLP) is a rare but potentially life-threatening hepatic disorder that leads to considerable maternal and fetal mortality. To explore the risk factors for maternal and fetal mortality in AFLP and develop new predictive models, through this retrospective study, we analyzed the demographic characteristics, clinical symptoms, and laboratory findings of 106 patients with AFLP who were admitted to Shandong Provincial Hospital. Risk factors for maternal and fetal mortality were analyzed by univariate and multivariate logistic regression analysis. The new models based on the multivariate logistic regression analysis and the model for end-stage liver disease (MELD) were tested in AFLP. The receiver operating characteristic curve (ROC) was applied to compare the predictive efficiency, sensitivity, and specificity of the two models. Prenatal nausea (p = 0.037), prolonged prothrombin time (p = 0.003), and elevated serum creatinine (p = 0.003) were independent risk factors for maternal mortality. The ROC curve showed that the area under the curve (AUC) of the MELD was 0.948, with a sensitivity of 100% and a specificity of 83.3%. The AUC of the new model for maternal mortality was 0.926, with a sensitivity of 90% and a specificity of 94.8%. Hepatic encephalopathy (p = 0.016) and thrombocytopenia (p = 0.001) were independent risk factors for fetal mortality. Using the ROC curve, the AUC of the MELD was 0.694, yielding a sensitivity of 68.8% and a specificity of 64.4%. The AUC of the new model for fetal mortality was 0.893, yielding a sensitivity of 100% and a specificity of 73.3%. Both the new predictive model for maternal mortality and the MELD showed good predictive efficacy for maternal mortality in patients with AFLP (AUC = 0.926 and 0.948, respectively), and the new predictive model for fetal mortality was superior to the MELD in predicting fetal mortality (AUC = 0.893 and 0.694, respectively). The two new predictive models were more readily available, less expensive, and easier to implement clinically, especially in low-income countries.

Download Full-text

Analysis of Risk Factors For Sepsis And Indicators of Prognosis In Patients With Sepsis: A Retrospective Observational Study

10.21203/rs.3.rs-577114/v1 ◽

2021 ◽

Author(s):

Huifeng Wang ◽

Zhiling Zhao ◽

Zhao-hui Tong

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Albumin Level ◽

Apache Ii ◽

Apache Ii Score ◽

Multivariate Logistic Regression ◽

Independent Risk Factors

Abstract Background: To investigate the independent risk factors for sepsis and the prognostic indicators of sepsis-related mortality to guide clinical practice.Methods: Adult patients diagnosed with sepsis in the respiratory intensive care unit (RICU), emergency ICU (EICU), and surgical ICU (SICU) of Beijing Chao-Yang Hospital, Capital Medical University, from January 2016 to April 2021 were enrolled. Comorbidities, complications, and laboratory indicators were retrospectively analyzed. Variables with a p value < 0.05 in the univariate analysis were entered into multivariate logistic regression analysis to identify the independent risk factors for sepsis. Receiver operating characteristic curve (ROC) analysis was used for those variables with P < 0.05 in multivariate regression to evaluate the fit of the predictive model and its prognostic efficacy. Results: A total of 123 adult patients with sepsis were enrolled, with 80 males and 43 females and a mean age of 61.56 ± 17.12 years. Acute respiratory distress syndrome (ARDS) occurred in 84 patients (68.3%), acute kidney injury (AKI) occurred in 28 patients (22.8%), acute myocardial injury (AMI) occurred in 6 patients (4.9%), disseminated intravascular coagulation (DIC) occurred in 14 patients (11.4%), septic shock occurred in 40 patients (32.5%), and 41 patients (33.3%) died. Multivariate logistic regression analysis showed that mean arterial pressure (MAP), acute physiology and chronic health evaluation II (APACHE II) score, albumin level, and the presence of DIC were independent risk factors for sepsis (P < 0.05). The area under the ROC curve for the model including MAP, albumin, and APACHE II score was the highest at 0.890.Conclusion: The MAP, APACHE II score, albumin level, and DIC were independent risk factors for sepsis. The inclusion of the MAP, albumin level, and APACHE II score in the model yielded the most accurate prediction of the risk of mortality.

Download Full-text