Risk factors for progressive ischemic stroke: A retrospective analysis

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BACKGROUND:Progressive ischemic stroke has higher fatality rate and disability rate than common cerebral infarction,thus it is very significant to investigate the early predicting factors related to the occurrence of progressive ischemic stroke,the potential pathological mechanism and the risk factors of early intervention for preventing the occurrence of progressive ischemic stroke and ameliorating its outcome. OBJECTIVE:To analyze the possible related risk factors in patients with progressive ishcemic stroke,so as to provide reference for the prevention and treatment of progressive ishcemic stroke. DESIGN:A retrospective analysis. SETTING:Department of Neurology,General Hospital of Beijing Coal Mining Group. PARTICIPANTS:Totally 280 patients with progressive ischemic stroke were selected from the Department of Neurology,General Hospital of Beijing Coal Mining Group from March 2002 to June 2006,including 192 males and 88 females,with a mean age of(62±7) years old. They were all accorded with the diagnostic standards for cerebral infarction set by the Fourth National Academic Meeting for Cerebrovascular Disease in 1995,and confired by CT or MRI,admitted within 24 hours after attack,and the neurological defect progressed gradually or aggravated in gradients within 72 hours after attack,and the aggravation of neurological defect was defined as the neurological deficit score decreased by more than 2 points. Meanwhile,200 inpatients with non-progressive ischemic stroke(135 males and 65 females) were selected as the control group. METHODS:After admission,a univariate analysis of variance was conducted using the factors of blood pressure,history of diabetes mellitus,fever,leukocytosis,levels of blood lipids,fibrinogen,blood glucose and plasma homocysteine,cerebral arterial stenosis,and CT symptoms of early infarction,and the significant factors were involved in the multivariate non-conditional Logistic regression analysis. MAIN OUTCOME MEASURES:Results of the univariate analysis of variance of the factors related to progressive ischemic stroke;Results of the multivariate regression analysis. RESULTS:All the 480 patients were involved in the analysis of results. ① Results of the univariate analysis variance:There were significantly more patients with fever,leukocytosis,history of diabetes mellitus,cerebral arterial stenosis and CT symptoms of early infarction in the progressive ischemic stroke group than in the control group(P < 0.01);The levels of blood glucose and fibrinogen in the progressive ischemic stroke group were significantly higher than those in the control group,while the level of blood pressure was significantly lower than that in the control group(P < 0.05-0.01). ② Results of the multivariate Logistic regression analysis:The independent predicting factors for progressive ischemic stroke were history of diabetes mellitus,fever,leukocytosis,cerebral arterial stenosis,CT symptoms of early infarction,blood glucose and blood pressure(OR =2.61,2.96,3.79,1.03,3.57,2.68,95% CI 0.92-3.59,P < 0.05-0.01). CONCLUSION:History of diabetes mellitus,fever,leukocytosis,levels of blood pressure,blood glucose,cerebral arterial stenosis and CT symptoms of early infarction are the risk factors for progress ischemic stroke BACKGROUND: Progressive ischemic stroke has higher fatality rate and disability rate than common cerebral infarction, thus it is very significant to investigate the early predicting factors related to the occurrence of progressive ischemic stroke, the potential pathological mechanism and the risk factors of early intervention for preventing the occurrence of progressive ischemic stroke and ameliorating its outcome. OBJECTIVE: To analyze the possible related risk factors in patients with progressive ishcemic stroke, so as to provide reference for the prevention and treatment of progressive ishcemic stroke. Department of Neurology, General Hospital of Beijing Coal Mining Group. PARTICIPANTS: Totally 280 patients with progressive ischemic stroke were selected from the Department of Neurology, General Hospital of Beijing Coal Mining Group from March 2002 to June 2006, including 192 males and 88 females, with a mean age of (62 ± 7) years old. They were all accor ded with the diagnostic criteria for cerebral infarction set by the Fourth National Academic Meeting for Cerebrovascular Disease in 1995, and confired by CT or MRI, admitted within 24 hours after attack, and the neurological defect progressed gradually or aggravated in gradients within 72 hours after attack , and the aggravation of neurological defect was defined as the neurological deficit score decreased more than 2 points. Meanwhile, 200 inpatients with non-progressive ischemic stroke (135 males and 65 females) were selected as the control group. METHODS: After admission, a univariate analysis of variance was conducted using the factors of blood pressure, history of diabetes mellitus, fever, leukocytosis, levels of blood lipids, fibrinogen, blood glucose and plasma homocysteine, cerebral arterial stenosis, and CT symptoms of early infarction, and the significant factors were involved in the multivariate non-conditional Logistic regression analysis. MAIN OUTCOME MEASURES: Results of the univariate analysis of variance of the factors related to progressive ischemic stroke; Results of the multivariate regression analysis. RESULTS: All the 480 patients were involved in the analysis of results. ① Results of the univariate analysis variance: There were significantly more patients with fever, leukocytosis , history of diabetes mellitus, cerebral arterial stenosis and CT symptoms of early infarction in the progressive ischemic stroke group than in the control group (P <0.01); The levels of blood glucose and fibrinogen in the progressive ischemic stroke group were significantly higher than those in the control group, while the level of blood pressure was significantly lower than that in the control group (P <0.05-0.01). ② Results of the multivariate Logistic regression analysis: The independent predicting factors for progressive ischemic stroke were history of diabetes mellitus , fever, leukocytosis, cerebral arterial stenosis, CT symptoms of early infarction, blood glucose and blood pressure (OR = 2. CONCLUSION: History of diabetes mellitus, fever, leukocytosis, levels of blood pressure, blood glucose, cerebral arterial stenosis and CT symptoms of early infarction are the risk factors for progress ischemic stroke
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