Risk factors for ischaemic stroke recurrence after hospitalisation

Research output: Journal Publications and Reviews (RGC: 21, 22, 62)21_Publication in refereed journalpeer-review

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Original languageEnglish
Pages (from-to)244-246
Journal / PublicationMedical Journal of Australia
Volume181
Issue number5
Publication statusPublished - 6 Sep 2004

Abstract

Objective: To determine risk factors for ischaemic stroke recurrence among patients admitted to hospital for a first-ever occurrence of ischaemic stroke. Design, setting and patients: Retrospective study involving linked hospitalisation and death records. The cohort comprised 7816 people who were hospitalised for first-ever ischaemic stroke between July 1995 and December 1999 in Western Australia. Cox's proportional hazards model was used to identify risk factors for stroke recurrence. Main outcome measures: Time to first recurrence; cumulative recurrence risk; risk factors for recurrence. Results: The median time to first stroke recurrence was 255 days. The cumulative probability of first recurrence was 5.1% (95% Cl, 4.6%-5.7%) at 6 months, 8.4% (95% Cl, 7.6%-9.1%) at 1 year and 19.8% (95% Cl, 18.1%-21.4%) at 4 years. The risk of first recurrence was increased by advancing age (hazard ratio [HR], 1.03; 95% Cl, 1.02-1.04), Aboriginality (HR, 1.50; 95% Cl, 1.02-2.22), diabetes (HR, 1.27; 95% Cl, 1.07-1.51), a history of cardiac conditions (HR, 1.18; 95% Cl, 1.01-1.38), post-stroke urinary incontinence (HR, 1.27; 95% Cl, 1.03-1.57) and transfer to another hospital on index admission (HR, 1.26; 95% Cl, 1.08-1.46). Admission at first stroke occurrence to a hospital maintaining a stroke unit reduced the risk of recurrence (HR, 0.84; 95% Cl, 0.72-0.99). Conclusion: The risk factors identified in our study have implications for planning secondary prevention strategies. In particular, Aboriginality and transfer to another hospital upon admission for first-ever ischaemic stroke were important risk factors. Research into the level of compliance and access to stroke treatment by Aboriginal patients to prevent further strokes is required.

Citation Format(s)

Risk factors for ischaemic stroke recurrence after hospitalisation. / Lee, Andy H.; Somerford, Peter J.; Yau, Kelvin K.W.

In: Medical Journal of Australia, Vol. 181, No. 5, 06.09.2004, p. 244-246.

Research output: Journal Publications and Reviews (RGC: 21, 22, 62)21_Publication in refereed journalpeer-review