Title:Stroke History is an Independent Risk Factor for Poor Prognosis in Ischemic Stroke Patients: Results from a Large Nationwide Stroke Registry
VOLUME: 17 ISSUE: 4
Author(s):Haiqiang Qin, Penglian Wang, Runhua Zhang, Miaoxin Yu, Guitao Zhang, Gaifen Liu* and Yongjun Wang*
Affiliation:Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing
Keywords:Ischemic stroke, risk factors, prognosis, registry, mortality, disability.
Abstract:
Background: There is some controversy whether stroke history is an independent risk
factor for poor prognosis of stroke or not. This study aimed to investigate the difference of mortality,
disability and recurrent rate of ischemic stroke patients without and with stroke history, as well
as to explore the effect of stroke history on stroke prognosis.
Methods: We analyzed patients with ischemic stroke enrolled in the China National Stroke Registry
which was a nationwide, multicenter, and prospective registry of consecutive patients with
acute cerebrovascular events from 2007 to 2008. Multivariable logistic regression was performed
to assess the risk of worse prognosis of stroke history in patients with ischemic stroke.
Results: A total of 8181(65.9%) patients without stroke history and 4234(34.1%) patients with
stroke history were enrolled in the study. The mortality, recurrence, modified Rankin Scale (mRS)
3-6 rate was 11.4%, 14.7% and 28.5% respectively at 1 year for patients without stroke history,
which was significantly lower than that of 17.3%, 23.6%, 42.1% in patients with stroke history, respectively.
Multivariable analysis showed that patients with stroke history had higher risk of death
[odds ratio (OR) 1.34,95% confidence interval (CI) 1.17-1.54], recurrence (OR 1.47, 95 % CI
1.31-1.65) and mRS 3-6 (OR 1.49,95% CI 1.34-1.66) at 1 year.
Conclusion: After adjusting for the potential confounders, stroke history was still an independent
risk factor for poor prognosis of ischemic stroke, which further emphasizes the importance of secondary
prevention of ischemic stroke. The specific causes of poor prognosis in patients with history
of stroke need to be furtherly investigated.
