西安市急性缺血性脑卒中患者早期脑卒中相关死亡发生情况及其危险因素分析

Ninety-day mortality and its risk factors among acute ischemic stroke patients in Xi’an city

目的了解陕西省西安市急性缺血性脑卒中(AIS)患者早期脑卒中相关死亡发生情况及其危险因素,为降低AIS患者发生早期死亡风险提供参考依据。方法收集西安市脑卒中数据库平台中西安市4所三级甲等医院2015年1—12月连续入院2340例AIS患者的相关临床资料和从入院确诊起90 d随访中发生死亡情况,分析AIS患者早期脑卒中相关死亡发生情况及其相关危险因素。结果西安市2340例AIS患者中,发生早期脑卒中相关死亡78例,早期脑卒中相关死亡比例为3.3%;多因素非条件logistic回归分析结果显示,年龄≥80岁(OR=4.487,95%CI=1.436~14.011)、神经功能重度损伤(OR=5.038,95%CI=1.781~14.244)、合并肺炎(OR=3.358,95%CI=1.679~6.713)、碱性磷酸酶水平较高(OR=1.007,95%CI=1.002~1.012)和白细胞计数水平较高(OR=1.128,95%CI=1.041~1.223)是西安市AIS患者发生早期脑卒中相关死亡的主要危险因素。结论西安市AIS患者发生早期脑卒中相关死亡的比例相对较低,高龄、神经功能重度损伤、合并肺炎、碱性磷酸酶和白细胞计数水平较高的AIS患者更易发生早期脑卒中相关死亡。

Objective To investigate the incidence and risk factors of early stroke-related mortality among acute ischemic stroke(AIS)patients in Xi′an city for providing evidences to reduce the mortality.Methods Totally 2340 AIS inpatients were consecutively enrolled throughout 2015 at 4 grade A tertiary hospitals in Xi′an city of Shannxi province.The inpatients′medical records and AIS-related information were collected and a 90-day follow-up survey was conducted for the inpatients.The mortality by the end of follow-up and risk factors for the mortality were analyzed.Results Among all the patients,78deaths were observed and the 90-day mortality was 3.3%.Multivariate unconditional logistic regression analysis revealed following significant risk factors for the early mortality:aged≥80 years(versus<50:odds ratio[OR]=4.487,95%confidence interval[95%CI]:1.436–14.011),severe neurological impairment(versus minor impairment:OR=5.038,95%CI:1.781–14.244),complicated with pneumonia(OR=3.358,95%CI:1.679–6.713),high alkaline phosphatase(OR=1.007,95%CI:1.002–1.012),and high leukocyte count(OR=1.128,95%CI:1.041–1.223).Conclusion Among AIS patients in Xi′an city,the early stoke-related mortality is relatively low and the patients at older age,with severe neurological impairment,complicated pneumonia,high alkaline phosphatase and high leukocyte count were at an increased risk of early mortality.