Time to recurrence after first-ever ischaemic stroke within 3 years and its risk factors in Chinese population: A prospective cohort study

Abstract

Objective This study aimed to estimate the time of recurrent ischaemic stroke events among the first 3 years of follow-up after hospitalisation discharge. Study design A prospective cohort study. Setting The research was conducted in the Department of Neurology at a tertiary hospital, Chengdu of China, from January 2010 to June 2016. Outcome measures We estimated the restricted mean survival time (RMST) of ischaemic stroke recurrence for the first 3 years after discharge. Basic sociodemographic characteristics and major potential risk factors for recurrence were collected using a semistructured questionnaire. Regression analysis of RMST was used to identify risk factors of recurrent stroke. Participants Patients hospitalised with first-ever ischaemic stroke were eligible for this study. Patients with severe cognitive impairment were excluded. Results We included 641 surviving patients who were followed up for 3 years. Stroke recurrence occurred in 115 patients, including 16 patients who died of stroke recurrence. The cumulative risk of stroke recurrence rate was 11.51% (9.20%-14.35%) at 1 year, 16.76% (13.96%-20.05%) at 2 years and 20.07% (17.00%-23.61%) at 3 years. Modified Rankin Scale (mRS) score ≥3 thus resulted in the recurrence time loss, which was 0.22 months (p=0.008) at 6 months, 0.61 months (p=0.004) at 1 year, 1.49 months (p=0.007) at 2 years and 2.46 months (p=0.008) at 3 years. It is similar with the effects of drug adherence after stroke. The recurrence time of patients ≥75 years at 3 years was 2.02 months (p=0.220) less than that of those aged <55 years. Conclusion In China, the time of first recurrence varies among different patients with ischaemic stroke. The mRS and the level of drug adherence after stroke are important risk factors of stroke recurrence.