Factors associated with prognosis after small-vessel occlusion among young and middle-aged patients: a hospital-based follow-up study. Issue 5 (4th July 2021)

• Record Type: Journal Article
• Authors: Guan, Yalin; Yu, Changshen; Zuo, Wenchao; Jia, Kun; Liu, Feng; Lu, Hui; Wang, Xiaodan; Wang, Dong; Wang, Xinping
• Is Part Of: Postgraduate medicine. Volume 133:Issue 5(2021)
• Page Start: 581
• Page End: 586
• Publication Date: 2021-07-04
• Subjects: Stroke -- small-vessel occlusion -- toast classification -- prognosis -- risk factors -- age; Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Periodicals; 610.5
• DOI: 10.1080/00325481.2021.1917250
• Languages: English
• ISSNs: 0032-5481

Abstract

ABSTRACT: Objective : Small-vessel occlusions are the most common causes of mild strokes and, in China, account for approximately 27.3% of ischemic stroke cases. However, the factors associated with short- and long-term outcomes appear contradictory. Thus, we assessed the factors related to outcomes 3 years after small-vessel occlusion among patients aged 18 to 55 years. Methods : Between 2007 and 2014, we recruited patients who experienced small-vessel occlusion (according to Trial of Org 10, 172 in Acute Stroke Treatment [TOAST] classification) aged 18 to 55 years and conducted a hospital-based follow-up study. The assessed outcomes were mortality, recurrence, and dependency within 3 years after the initial stroke. The outcome determinants were assessed using a multivariate logistic regression analysis. Results : A total of 276 patients (men, 76.09%) with small-vessel occlusions were enrolled in this study. In addition, 85.1% of the patients had strokes between the ages of 45 and 55 years. The risk of recurrence within 3 years was higher for patients who had moderate strokes than for those who had mild events (relative risk [RR], 3.09; 95% confidence interval [CI], 1.14–8.34; P < 0.05). Further, the risk of dependency within 3 years was 2.61 times higher in obese patients than in non-obese patients (RR, 2.61; 95% CI, 1.00–6.79; P < 0.05). The risks of recurrence and dependency within 3 years increased by 17% and 18%, respectively, for each 1-unit increase in fasting plasma glucose levels (RR, 1.17; 95% CI, 1.05–1.30 and RR, 1.18; 95% CI, 1.06–1.32, respectively; both P < 0.05). Conclusion : Our findings suggest that small-vessel occlusions cause the heaviest disease burden in patients aged 45 to 55 years. To reduce stroke recurrence, young and middle-aged patients with small-vessel occlusions should control their fasting plasma glucose levels and manage their weight.