Analysis of the Risk Factors for the Recurrence of Ischemic Stroke with Diabetes Mellitus and Establishment of Cox’s Regression Model and the Personal Prognosis Index in Two Years of Follow-Up
Vol. 22 No. 7 (2020), Research articles
Vol. 22 No. 7 (2020)

Analysis of the Risk Factors for the Recurrence of Ischemic Stroke with Diabetes Mellitus and Establishment of Cox’s Regression Model and the Personal Prognosis Index in Two Years of Follow-Up

Research articles
Published 2020-07-27
Ya-Chen An
North China University of Science and Technology Affiliated Hospital, Tangshan, China
Yu-Xun Wang
North China University of Science and Technology Affiliated Hospital, Tangshan, China
Yan-Ru Jiang
Tangshan City Hospital of Traditional Chinese Medicine, Tangshan, China
Yan-Zheng Li
North China University of Science and Technology Affiliated Hospital, Tangshan, China
Jing-Yu Feng
North China University of Science and Technology Affiliated Hospital, Tangshan, China
Song-Xin Shi
North China University of Science and Technology Affiliated Hospital, Tangshan, China
Jing-Jun Chen
North China University of Science and Technology Affiliated Hospital, Tangshan, China
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Keywords

Ischemic Stroke
Recurrence Rate
Risk Factors
Type 2 Diabetes Mellitus
Cox Proportional Hazard Regression Model

How to Cite

An, Y.-C. . ., Wang , Y.-X. ., Jiang , Y.-R., Li , Y.-Z. ., Feng , J.-Y. ., Shi , S.-X. ., & Chen, J.-J. . (2020). Analysis of the Risk Factors for the Recurrence of Ischemic Stroke with Diabetes Mellitus and Establishment of Cox’s Regression Model and the Personal Prognosis Index in Two Years of Follow-Up. Iranian Red Crescent Medical Journal, 22(7). Retrieved from https://ircmj.com/index.php/IRCMJ/article/view/694
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Abstract

Background: Ischemic stroke is a major cause of disability and mortality in patients with type 2 diabetes mellitus (T2DM), and diabetic stroke has a high recurrence rate.

Objectives: This prospective cohort study aimed at investigating the risk factors and establishing Cox’s regression model and per- sonal prognosis index for the recurrence of ischemic stroke at a two-year follow-up in T2DM patients.

Methods: T2DM patients with ischemic stroke, who were consecutively admitted to the Neurology Department of North China Uni- versity of Science and Technology Affiliated Hospital between January 1, 2015, and December 31, 2015, were retrospectively reviewed. These cases were followed up since the onset of ischemic stroke for 2 years. Univariate and multivariate Cox’s proportional haz- ard regression model was used to analyze risk factors associated with the recurrence rate. Thus, a recurrence model and personal prognosis index were set up.

Results: During the follow-up period, 44 cases relapsed. Furthermore, the 1-year recurrence rate was 16.48%, while the 2-year recur- rence rate was 24.18%. The univariate and multivariate Cox proportional hazard regression model revealed that the independent risk factors associated with recurrence were TOAST criteria (X1) (RR = 1.663; 95% CI = 1.015 - 2.760, P = 0.032), hypertension grade (X2) (RR = 1.897; 95% CI = 1.097 - 3.280, P = 0.022), duration of diabetes mellitus (X3) (RR = 1.151; 95% CI = 1.009 - 1.991, P = 0.039), total cholesterol (X4) (RR = 1.13; 95% CI = 1.006 - 1.876, P = 0.035), and Essen stroke risk score (ESRS) (X5) (RR = 2.055; 95% CI = 1.357 - 3.134, P = 0.001). The

personal prognosis index of the recurrence model was as follows: PI = 0.504 X1 + 0.640 X2 + 0.345 X3 + 0.759 X4 + 0.823 X5. Conclusions: TOAST criteria, hypertension grade, duration of diabetes mellitus, total cholesterol, and ESRS were the independent risk factors associated with the recurrence of ischemic stroke with diabetes mellitus. The recurrence model and personal prognosis index equation were successfully established.

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