Characteristics of risk factors for ischemic stroke recurrence and death in Western China: a retrospective study

Abstract

Background Ischemic stroke (IS) has the characteristics of high recurrence and mortality rates. This study aimed to investigate the recurrence and mortality rates of IS patients one year after their first-episode IS and to analyze the related risk factors for the recurrence of IS and death after recurrence. Methods The clinical history and laboratory data of patients who were hospitalized and diagnosed with first-episode IS from 2020 to 2021 were collected, and retrospective analysis was conducted after tracking the recurrence of IS in the patients for one year. Outcome events were defined as recurrence or death after recurrence within one year after the patients’ stroke, excluding other causes of neurological deterioration. Univariate analysis and multivariate logistic regression analysis were conducted to determine the risk factors associated with stroke recurrence. Results A total of 1,052 patients with IS were included in this study. The recurrence rates at three, six, and 12 months were 2.75%, 6.27%, and 11.97%, respectively. The mortality rate after recurrence within one year was 5.13%. The patients’ recurrence time nodes, age, National Institutes of Health Stroke Scale (NIHSS) score, high-density lipoprotein (HDL), platelet count, and hemoglobin were independent influencing factors of recurrence within three months after the first-episode IS. The NIHSS score, HDL, low-density lipoprotein (LDL), platelet count, and creatinine were independent influencing factors of recurrence within six months after the first-episode IS. On the timeline of one year after the patients’ stroke, the common independent influencing factors of IS recurrence were the NIHSS score and HDL, among which the NIHSS score was positively correlated with stroke recurrence, while HDL was negatively correlated with stroke recurrence. Conclusions The study found that there was a high risk of stroke recurrence and death within one year after the first-episode IS; thus, there is an urgent need to improve the secondary prevention of stroke to reduce this risk. Through analysis, it was concluded that various risk factors were associated with recurrence. Therefore, Chinese medical staff and healthcare workers should focus on the secondary prevention of stroke, which includes the development and implementation of effective prevention strategies to prevent stroke recurrence and improve the long-term prognosis of stroke survivors.