scholarly journals Comparison of metabolic phenotypes and BMI as indicators of recurrent stroke in Chinese hospitalized stroke patients: a retrospective study

2021 ◽  
Author(s):  
Xiaolin Huang ◽  
Jiaojiao Zhou ◽  
Hong Zhang ◽  
Pei Gao ◽  
Long Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Recurrent Stroke ◽  
Population Based ◽  
Metabolic Status ◽  
Stroke Patients ◽  
Population Based Study ◽  
Metabolic Phenotypes ◽  
History Of ◽  
Integrated Discrimination Improvement ◽  
Conventional Risk Factors

Abstract Background Metabolic status and body mass index (BMI) are known as apparent risk factors of recurrent stroke, but which one is more likely related to recurrent stroke remains uncertain. This study aimed to compare the metabolic phenotypes and BMI as indicators of recurrent stroke in Chinese hospitalized stroke patients. Methods In this retrospective population-based study, 856 hospitalized stroke patients from the Third Affiliated Hospital of Soochow University were enrolled. Recurrent stroke was defined as newly-onset stroke patients with a history of previous stroke. Metabolic phenotypes were based on Adult Treatment Panel III criteria. BMI ≥ 25kg/m2 was defined as obesity. Results Among the hospitalized stroke patients, the prevalence of recurrent stroke was 21.9%. Metabolic phenotypes rather than BMI were significantly associated with recurrent stroke. Compared with metabolically healthy patients, metabolically unhealthy ones had 72% (odds ratio [OR] = 1.72, 95% confidence interval [CI] 1.01–2.68) increased recurrent stroke, regardless of BMI and other confounding factors. Whereas, no statistical association between BMI and recurrent stroke were found. Metabolic status improved risk prediction of recurrent stroke when adding to conventional risk factors (net reclassification index 17.6%, P = 0.0047; integrated discrimination improvement 0.7%, P = 0.014), while BMI did not. Conclusions Recurrent stroke was likely associated with poor metabolic status rather than with BMI, suggesting that controlling metabolic abnormalities could be an important method for recurrent stroke prevention.

scholarly journals Metabolic Abnormalities Rather Than BMI, Associated With Increased Risk of Recurrent Stroke in Chinese Hospitalized Stroke Patients: A Retrospective Study

2021 ◽  
Author(s):  
Xiaolin Huang ◽  
Jiaojiao Zhou ◽  
Hong Zhang ◽  
Pei Gao ◽  
Long Wang ◽  
...  
Keyword(s):  
Factor Model ◽  
Recurrent Stroke ◽  
Population Based ◽  
Metabolic Abnormalities ◽  
Stroke Patients ◽  
Conventional Risk Factor ◽  
Metabolic Phenotypes ◽  
Risk Factor Model ◽  
Increased Risk ◽  
History Of

Abstract Background Metabolic abnormalities and body mass index (BMI) are known as apparent risk factors of recurrent stroke, but which one is more likely related to recurrent stroke remains uncertain. This study aimed to compare the metabolic phenotypes and BMI as indicators of recurrent stroke in Chinese hospitalized stroke patients. Methods In this retrospective population-based study, 856 hospitalized stroke patients from the Third Affiliated Hospital of Soochow University were enrolled. Recurrent stroke was defined as newly-onset stroke patients with a history of previous stroke. Metabolic phenotypes were categorized based on Adult Treatment Panel III criteria. BMI ≥ 25kg/m2 was defined as obesity. Results Among the hospitalized stroke patients, the prevalence of recurrent stroke was 21.9%. Metabolic abnormalities rather than BMI were significantly associated with recurrent stroke. Compared with metabolically healthy patients, metabolically unhealthy ones had 72% (odds ratio [OR] = 1.72, 95% confidence interval [CI] 1.01–2.68) increased risk of recurrent stroke, regardless of BMI and other confounding factors. Whereas, no statistical association between BMI and recurrent stroke were found. Metabolic status significantly improved risk prediction of recurrent stroke when adding to the conventional-risk-factor model (net reclassification index 17.6%, P = 0.0047; integrated discrimination improvement 0.7%, P = 0.014), while BMI did not. Conclusions Recurrent stroke is likely associated with metabolic abnormalities rather than with BMI. For the secondary prevention of stroke, controlling metabolic abnormalities is a more crucial method then BMI controlling in stroke patients.

scholarly journals The Association between Substance Use Disorders and Long-Term Outcome of Stroke: Results from a Population-Based Study of Stroke among 450,229 Urban Citizens

2021 ◽  
pp. 1-9
Author(s):  
Mohammad Sobhan Sheikh Andalibi ◽  
Amir Rezaei Ardani ◽  
Amin Amiri ◽  
Negar Morovatdar ◽  
Amirhossein Talebi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Substance Use ◽  
Population Based ◽  
Functional Dependency ◽  
Stroke Mortality ◽  
Vascular Risk ◽  
Population Based Study ◽  
Stroke Outcomes ◽  
History Of

<b><i>Introduction:</i></b> Little is known regarding long-term stroke outcomes in patients with substance use disorder (SUD). Based on anecdotal data, some individuals use illicit drugs, particularly opioids, in an attempt to reduce stroke mortality, disability, or recurrence. This study is aimed to assess the effect of SUD on stroke outcomes. <b><i>Methods:</i></b> Patients were recruited from the Mashhad Stroke Incidence Study, a population-based study of stroke in Iran. For a period of 1 year, all patients with first-ever stroke (FES) were recruited and then followed up for the next 5 years. Disability and functional dependency were defined using modified Rankin Scale (&#x3e;2) and Barthel Index (&#x3c;60), respectively. We compared the cumulative rates of mortality in follow-up points using the log-rank test. We used multivariable logistic, Cox regression and competing risk models to assess adjusted hazard ratio (aHR) with 95% confidence interval (CI) of stroke disability, functional dependency, mortality, and recurrence among those with a history of SUD. <b><i>Results:</i></b> 595 FES patients (mean age of 64.6 ± 14.8 years) were recruited in this study. Eighty-one (13.6%) were current substance users, including opium (<i>n</i> = 68), naswar (<i>n</i> = 5, 6.1%), hashish (<i>n</i> = 1), heroin (<i>n</i> = 1), and (<i>n</i> = 7) others. The frequency of vascular risk factors was similar between the SUD and non-SUD groups, except for a higher rate of cigarette smoking in the SUD group (<i>p</i> &#x3c; 0.001). After adjusting for various sociodemographic variables, vascular risk factors, and the severity of stroke at admission, SUD increased the 3-month (aHR: 1.60, CI: 1.01–2.49), 1-year (aHR: 1.73, CI: 1.20–2.65), and 5-year (aHR: 1.72, CI: 1.23–2.35) poststroke mortality risk. We did not observe a significant change in the risk of stroke recurrence, disability, and functional dependency in those with a history of SUD. <b><i>Conclusion:</i></b> SUD increased the hazard ratio of stroke mortality with no effect on the disability rate. The public should be advised about the potential harm of substance abuse.

scholarly journals Nosocomial Vs. Community-Acquired Infective Endocarditis in Spain: Location, Trends, Clinical Presentation, Etiology, and Survival in the 21st Century

2019 ◽  
Vol 8 (10) ◽  
pp. 1755 ◽  
Author(s):  
Christian Ortega-Loubon ◽  
María Fe Muñoz-Moreno ◽  
Irene Andrés García ◽  
Francisco Javier Álvarez ◽  
Esther Gómez-Sánchez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Infective Endocarditis ◽  
Population Based ◽  
Charlson Index ◽  
Cardiac Device ◽  
Population Based Study ◽  
Stroke Risk Factors ◽  
The North ◽  
Cardiac Devices ◽  
History Of

Major changes have occurred in the epidemiology and etiology of infective endocarditis (IE). Nevertheless, the differences between nosocomial infective endocarditis (NIE) and community-acquired infective endocarditis (CIE) have not been addressed in a population-based study. We conducted a retrospective, nationwide, temporal trend study from 1997 to 2014 analyzing the epidemiology, clinical, geographical, meteorological characteristics of patients diagnosed with IE in Spain, to distinguish NIE from CIE. Among 25,952 patients with IE (62.2 ± 18·6 years; 65.9% men), 45.9% had NIE. The incidence of IE increased from 2.83 to 3.73 due to the NIE incidence increment with a decline in CIE. Patients with NIE were older (63.8 years vs. 60.8 years, p < 0·001), presented a higher Charlson index (1.22 vs. 1.03, p < 0.001), a greater history of implanted cardiac devices (8.7% vs. 4.6%, p < 0.001), and higher mortality (31.5% vs. 21.7%, p < 0.001). The most frequent microorganism for both NIE and CIE was Staphylococcus (p < 0.001), and the North reported a higher incidence (p < 0.001). Risk factors of mortality for NIE were age, Charlson index, hemodialysis, shock, heart failure, and stroke. Risk factors for CIE included female sex, renal disease, and cardiac-device carriers. The etiology of IE shifted from community origins to mostly nosocomial-associated infections. Higher morbidity, mortality, and poorer outcomes are associated with NIE.

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