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Mortality and Stroke Recurrence in a Rehabilitation Cohort of Patients with Cerebral Infarcts and Chagas Disease
- Source :
- European Neurology. 79:177-184
- Publication Year :
- 2018
- Publisher :
- S. Karger AG, 2018.
-
Abstract
- Background: Chagas disease is related to ischemic stroke (IS), although few epidemiological studies have evaluated the associated mortality and recurrence. Our objective is to determine factors associated with mortality and recurrence of IS in patients with IS and Chagas disease. Methods: We retrospectively studied data obtained from electronic medical records of patients admitted at SARAH Hospitals across Brazil between 2009 and 2013. Using Cox regression analysis for mortality and logistic regression for recurrence, we assessed primary population characteristics and statistical associations between risk factors and outcomes. Results: We analyzed 279 patients who were followed up until 2016. The mean age at stroke onset was 61 with a 10% frequency of death. Multivariate analysis assessing mortality demonstrated that the associated factors were age at stroke (hazard ratio [HR] 1.04), initial modified Rankin Scale (mRS; HR 20.91), bladder dysfunction (HR 2.51), diabetes mellitus (DM; HR 3.64), and alcoholism (HR 3.37). Multivariate analysis assessing recurrence demonstrated that the associated factors were age at ictus (OR 0.96), cognitive deficit (OR 0.44), initial mRS (OR 1.84), cardioembolic etiology (OR 2.47), and female sex (OR 2.73). Conclusions: Cardiac conditions did not correlate with mortality or recurrence. Age was a protective factor against recurrence, probably due to cumulative risk of IS over time, while initial mRS was associated with both outcomes. Treating diseases such as DM and bladder dysfunction, and early treatment to reduce the initial mRS could potentially prevent both outcomes; also, establishing a correct etiological diagnosis is important.
- Subjects :
- Male
medicine.medical_specialty
Population
030204 cardiovascular system & hematology
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Recurrence
Risk Factors
Modified Rankin Scale
Internal medicine
Epidemiology
medicine
Humans
Chagas Disease
education
Stroke
Aged
Proportional Hazards Models
Retrospective Studies
education.field_of_study
business.industry
Proportional hazards model
Hazard ratio
Cerebral Infarction
Middle Aged
medicine.disease
Logistic Models
Neurology
Multivariate Analysis
Cohort
Etiology
Female
Neurology (clinical)
business
Brazil
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 14219913 and 00143022
- Volume :
- 79
- Database :
- OpenAIRE
- Journal :
- European Neurology
- Accession number :
- edsair.doi.dedup.....aa2ba2fbe0c09ddc994d27dacf828bfb