Title:Analysis of Prognostic Risk Factors for Ischemic Stroke in China: A Multicentre
Retrospective Clinical Study; A National Survey in China
Volume: 19
Issue: 1
Author(s): Yuting Cao, Ying Chen, Xiaoli Zhang and Yongjun Wang*
Affiliation:
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University,
Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Keywords:
Sex, ischaemic stroke, functional prognosis, stroke recurrence, mortality, public health.
Abstract:
Background: Stroke is a serious disease that threatens human health both in China and
worldwide. Identifying and establishing its risk factors are prerequisites for intervention and evaluation
of prognosis. Over the years, risk factors, such as age, diabetes, and hypertension, have gradually
been established. However, at present, there is no consensus on the influence of sex on the prognosis
of ischaemic stroke.
Aims: The aims of our research was to analyse the correlation between sex and poststroke prognosis
based on the results of the Third China National Stroke Registry [CNSR-III], as well as the influence
of other risk factors that may be confounded by sex on ischaemic stroke and potential interventions.
Methods: The CNSR-III recruited 14146 acute ischaemic stroke [AIS] patients between 2015 and
2018. Our study included 13,972 patients who had complete follow-up information. This research
analysed basic information, socioeconomic status, lifestyle habits, medical history, and poststroke
prognosis.
Results: There was a conspicuous relationship between sex and functional prognosis, stroke recurrence
and all-cause death due to ischemic stroke in univariate analysis. Male stroke patients had a
better prognosis than female patients. In multivariate analysis, we found that age, atrial fibrillation
[AF], diabetes, hypertension and the severity of stroke had adverse effects on ischemic stroke prognosis.
After adjustment for other risk factors, the functional prognosis of female patients at 3 months
was worse than that of male patients [odds ratio [OR] 1.16, 95% confidence interval [CI], 1.025-
1.314]. Sex had a nonsignificant association with stroke recurrence at 3 months [hazard ratio [HR]
1.141, 95% CI, 0.975-1.336]. Furthermore, compared to male patients, female stroke patients had a
lower cumulative death rate at 12 months [HR 0.777, 95% CI, 0.628-0.963].
Conclusion: Our study identified sex differences in stroke-related disability, recurrence, and death
and attempted to explain the causes of these differences. Our study clearly showed that a large proportion
of this difference could be attributed to age, socioeconomic factors, lifestyle habits, and
medical history, confounded by sex differences rather than sex per se.
