中国卒中杂志2019，Vol.14Issue(6)：578-584,7.DOI:10.3969/j.issn.1673-5765.2019.06.011
西安地区伴心房颤动老年急性缺血性卒中患者临床特征及1年预后分析
Clinical Characteristics and 1-Year Prognosis in Elderly Acute Ischemic Stroke Patients with Atrial Fibrillation in Xi'an Area
摘要
Abstract
Objective To investigate the clinical characteristics and 1-year prognosis of elderly acute ischemic stroke (AIS) patients with atrial fibrillation (AF) in Xi'an area. Methods Clinical data of elderly patients with AIS (≥65 years) who were consecutively admitted to four tertiary-grade A class hospitals from January 2015 to December 2015 in Xi'an Stroke Data Bank were collected. The clinical characteristics of elderly AIS patients with and without AF were compared, and the outcome events of 1 year follow-up (including stroke recurrence, death and poor prognosis) were analyzed. Multivariate logistic regression analysis was used to find the independent risk factors for poor prognosis of 1 year in elderly AIS patients with AF in Xi'an area. Results Total 1239 elderly AIS patients were enrolled in this study, including 133 (10.7%) patients with AF. Comparing with the non-AF group, the elderly AIS patients in AF group showed older [(77.7±6.3) years vs (74.0±6.1) years, P=0.019], higher mRS score at discharge (median 2.0 vs 1.0, P<0.001), higher rate of NIHSS score≥14 at discharge (16.5% vs 3.1%, P<0.001), higher rate of patients with pneumonia (21.1% vs 5.8%, P<0.001), more patients unable to walk within 48 h at admission (63.0% vs 36.1%, P<0.001), higher fasting blood glucose level [6.3±3.0) mmol/L vs (5.8±2.0) mmol/L, P=0.037] and lower LDL-C level [(2.4±0.7) mmol/L vs (2.5±0.8) mmol/L, P=0.031] at admission. At 1 year follow-up, the elderly AIS patients in AF group had higher stroke recurrence rate (15.8% vs 5.9%, P=0.020), higher mortality (32.3% vs 9.2%, P<0.001) and higher rate of poor prognosis (51.9% vs 25.9%, P<0.001) than that in non-AF group. After adjustment for the related confounders, multivariate logistic regression analysis result showed that AF was an independent risk factor for 1 year mortality in elderly AIS patients ( OR 2.45, 95% CI 1.26-4.78, P=0.008), but not an independent risk factor for stroke recurrence and poor prognosis at 1 year (P>0.05). Conclusions Comparing with the elderly AIS patients without AF, the elderly AIS patients with AF in Xi'an area were older, had more severe stroke, higher rate of pneumonia and higher rate of losing the ability to walk within 48h at admission, and higher risk of death at 1 year.关键词
老年/急性/缺血性卒中/心房颤动/预后Key words
Elderly/Acute/Ischemic stroke/Atrial fibrillation/Prognosis引用本文复制引用
刘仲仲,吴松笛,蔺雪梅,段康丽,逯青丽,曹欢,王静,王芳,史亚玲,王清..西安地区伴心房颤动老年急性缺血性卒中患者临床特征及1年预后分析[J].中国卒中杂志,2019,14(6):578-584,7.基金项目
西安市科技计划基金资助项目[SF1211(1)]陕西省科技计划基金资助项目(2017SF163)西安市卫生局科技项目(J201703049)西安市科技计划基金资助项目[201805104YX 12SF38(2)] （1）
