18 Zhang et al
World J Emerg Med, Vol 2, No 1, 2011
Original Article
Clinical factors in patients with ischemic versus hemorrhagic stroke in East China Jing Zhang, Yao Wang, Gan-nan Wang, Hao Sun, Tao Sun, Jian-quan Shi, Hang Xiao, Jin-song Zhang Department of Emergency Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China (Zhang J, Wang Y, Wang GN, Sun H, Zhang JS); Department of Epidemiology and Biostatistics, Nanjing Medical University, Nanjing 210029 China (Sun T); Department of Neurology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China (Shi JQ); Laboratory of Neurotoxicology, School of Public Health, Nanjing Medical University, Nanjing 210029, China (Xiao H) Corresponding Author: Jin-song Zhang, Email:
[email protected]
BACKGROUND: Stroke is one of the leading causes of mortality and morbidity of vascular diseases, and its incidence maintains at a high level around the world. In China, stroke has been a major public health problem. Because the pathogenesis of ischemic stroke is different from that of hemorrhagic stroke, their clinical factors would not be the same. Therefore to investigate the different effects of various effect factors on ischemic versus hemorrhagic stroke and then to enhance the prevention are crucial to decrease the incidence. METHODS: A total of 692 patients, consisting of 540 ischemic stroke patients and 152 hemorrhagic stroke patients from East China, were included in this study. The related factors of stroke subtypes were collected and analyzed. RESULTS: The factors significantly associated with ischemic stroke as opposed to hemorrhagic stroke were family history of stroke, obesity, atherosclerotic plaque of the common carotid artery, atrial fibrillation, hyperfibrinogenemia, transient ischemic attack (TIA), atherosclerotic plaque of the internal carotid artery, coronary heart, lower high-density lipoproteins (lower HDL), increasing age, diabetes mellitus, and gender (male) (P55 years, female>65 years [5] ), gender (male-exposure), cigarette smoking (average smoking≥1 cigarettes per day, and continued more than one year), alcohol drinking (at least 1 time per week, alcohol consumption≥50 mL and more than 3 months), obesity (body mass index (BMI)≥28 kg/m2); family history of coronary artery disease (CAD), stroke, hypertension and diabetes mellitus (DM); history of
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hypertension (in line with the diagnostic criteria of China Guidelines of Hypertension Updated 2005), increased pulse pressure (>40 mmHg), atrial fibrillation (AF), DM (in line with the diagnostic criteria of WHO1999), valvular heart diseases, CAD, transient ischemic attack (TIA), peripheral arterial thrombosis, peptic ulcer disease, kidney disease; elevated systolic blood pressure (SBP≥140 mmHg), elevated diastolic blood pressure (DBP ≥90 mmHg), increased white blood cell (WBC>10.0×109/L), hypertriglyceridemia (triglyceride (TG)>1.7 mmol/L), hypercholesterolemia (total cholesterol (TC)≥5.7 mmol/L), low level of high-density lipoproteins (HDL4.0 g/L); ischemic ECG changes, ECG arrhythmia; and the formation of carotid atheroma, common carotid atheroma and vertebral artery stenosis shown by carotid ultrasound.
Statistical analysis Statistical analysis were performed by the SPSS 16.0 package. The continuous clinical variants were compared by unpaired Student's t test. The Chi-square test was used to evaluate differences in proportion of clinical factors in patients between ischemic and hemorrhagic stroke. We used logistic regression analysis to calculate odds ratio (OR) of the incidence of ischemic stroke versus hemorrhagic stroke and of incidence of ischemic stroke (hemorrhagic stroke) in men versus in women and 95% confidence interval.[5,6] A P value
