Long-term prognosis and prognostic determinants of patients with first attack of mild and moderate ischemia at Beijing community hospitals

• Published in: Neural regeneration research Vol. 7; no. 7; pp. 540 - 545
• Main Authors: Fang, Xianghua, Li, Liming, Zhang, Xinqing, Liu, Hongjun, Zhang, Hongmei, Qin, Xiaoming
• Format: Journal Article
• Language: English
• Published: India Medknow Publications & Media Pvt. Ltd 05.03.2012; Department of Evidence-based Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China%Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Sciences Center, Beijing 100191, China%Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China%Department of Evidence-based Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China%Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing 100053, China; Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Sciences Center, Beijing 100191, China; Medknow Publications & Media Pvt Ltd
• Subjects: Activities of daily living; Cardiovascular disease; Clinical Practice; Diabetes; Disease prevention; Enrollments; Fatalities; Heart attacks; Hospitals; Ischemia; Medical prognosis; Mortality; Patients; Stroke; 北京; 医院; 急性心肌梗死; 患者; 比例危险率模型; 社区; 缺血; 预后; Beijing China; China; predictors; recurrent stroke; follow-up study; prognosis; ischemic stroke; survival
• ISSN: 1673-5374; 1876-7958
• DOI: 10.3969/j.issn.1673-5374.2012.07.011

A total of 710 patients with first-ever ischemic stroke were consecutively recruited between January 2003 and December 2004 from five community hospitals/stations in five districts of Beijing, China. As of December 31, 2008, a total of 2 477 person-years were followed-up. During the five-year follow-ups, 117 adverse events occurred, including all-cause death and acute cardiovascular events （recurrent stroke, acute myocardial infarction, and sudden death）. The five-year cumulative mortality rate was 2.18/100 person-years （54 cases）, with 3.88/100 person-years （96 cases） of acute cardiovascular events and 3.02/100 person-years （75 cases） of recurrent stroke. Multiple factor analyses using the Cox proportional hazards ratio models showed that age, diabetes, and dependence of activities of daily living were independent predictors for death, acute cardiovascular disease events, or recurrent stroke. The results demonstrated that recurrent stroke was a major vascular disease that affected the prognosis of mild or moderate stroke patients. Secondary prevention of stroke patients should include active management of vascular risk factors and rehabilitation.