Risk factors influencing to mortality and recurrence after first cerebral infarction

Kim, Jai Young; Hwang, Ji Hwan; Choi, Jin Young; Cho, Dong Young; Yu, Byung Yeon

Abstract

BACKGROUND: Cerebral infarction is one of the common cause of death in Korea. There are many studies about risk factors of cerebral infarction in the world and Korea, and there are some studies about risk factors of mortality and recurrence after first cerebral infarction in the world, but there are no reliable epidemiologic studies about risk factors of mortality and recurrence after first cerebral infarction in Korea. So this study was designed to investigate the risk factors of mortality and recurrence after first cerebral infarction in Korea.
METHODS
A cohort of 257 patients with diagnosing first cerebral infarction at our hospital were selected and followed for at least 5 years. 30 days, 1 year, 5 year cumulative mortality and recurrence was calculated. Risk factors classified at the time of first cerebral infarction, and then entered into a Cox proportional harzards model for mortality and for recurrence.
RESULTS
The cumulative risk of mortality after first cerebral infarction was 13% at 30days, 21% at 1year, 49% at 5years. The cumulative risk of recurrence after first cerebral infarction was 4% at 30days, 11% at 1year, 24% at 5years. The significant risk factors of mortality after first cerebral infarction were age(> OR =65), heavy alcohol drinking history, heart failure, untreated diabetes mellitus history, untreated hypertension history, high admission Hct(> OR =50%), high admission glucose(> OR =200), atrial fibrillation at admission, under drowsy mental state at admission, embolic infarction type, high admission systolic blood pressure(> OR =160), high admission diastolic blood pressure(> OR =100). The significant risk factors of recurrence were age(<65), men, heavy alcohol drinking history, ischemic heart disease, untreated DM history, high admission glucose(> OR =200).
CONCLUSION
Diabetes mellitus, hypertension, heavy alcohol drinking, cardiovascular disease were important factor of cerebral infarction prognosis on our study. So primary care physicians focus on these factors when treating cerebral infarction patient.