Back to Journals » Risk Management and Healthcare Policy » Volume 14

A Nomogram to Predict Lifestyle Factors for Recurrence of Large-Vessel Ischemic Stroke

Authors Huang ZX, Yuan S, Li D, Hao H, Liu Z, Lin J

Received 4 November 2020

Accepted for publication 8 January 2021

Published 2 February 2021 Volume 2021:14 Pages 365—377

DOI https://doi.org/10.2147/RMHP.S289761

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Professor Marco Carotenuto


Zhi-Xin Huang, 1– 3 Shumin Yuan, 4 Dongshi Li, 1, 3 Hong Hao, 2 Zhenguo Liu, 2 Jianguo Lin 1, 3

1Department of Neurology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, China; 2Center for Precision Medicine and Division of Cardiovascular Medicine, Department of Medicine, University of Missouri School of Medicine, Columbia, MO, USA; 3Department of Neurology, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China; 4Department of Biochemistry and Molecular Biology, Guilin Medical University, Guilin, Guangxi, China

Correspondence: Zhi-Xin Huang
Department of Neurology, Guangdong Second Provincial General Hospital, 466 Middle Xingang Road, Guangzhou, 510317, Guangdong, China
Tel/Fax +86 20 89168080
Email hzxd6@163.com

Zhenguo Liu
Center for Precision Medicine and Division of Cardiovascular Medicine, Department of Medicine, University of Missouri School of Medicine, Columbia, MO, USA
Email liuzheng@health.missouri.edu

Background: Stroke is the leading cause of morbidity and mortality in China. Recurrent stroke (RS) could occur in a significant portion of patients with ischemic stroke with devastating consequence.
Methods: To investigate the association between lifestyle and the risk of RS in Chinese patients with acute large-vessel ischemic stroke (ALVIS). A total of 258 patients with ALVIS were recruited in the study (median age 63 years, 30.6% female), and followed for a median of 366 days. The primary outcomes were first RS. Cox Regression and Akaike information criterion were used to establish the best-fit nomograms.
Results: During follow-up, 38 of 258 (14.7%) participants had the primary endpoint event. After adjusting for confounding factors in multivariate Cox regression analysis, healthy lifestyles, including bland diet (hazard ratio [HR], 0.365; 95% CI, 0.138– 0.965), daily fruit consumption (HR, 0.474; 95% CI, 0.238– 0.945), good sleep (HR, 0.364; 95% CI, 0.180– 0.739), housework: HR (0.461; 95% CI, 0.200– 1.065), and HDL (HR, 0.329; 95% CI, 0.130– 0.831) were associated with significantly decreased risk for RS after ALVIS, while smoking was associated with a substantial increase in RS risk (HR, 2.590; 95% CI, 1.340– 5.005) and included into the nomogram. A weighted point (from 0 to 100) was given to each risk factor, and the total points could be used to predict the probability of RS for the patient.
Conclusion: The nomogram shows that healthy lifestyles (bland diet, daily fruit consumption, good sleep, cigarette cessation, and housework) were important for reducing RS in patients with ALVIS.

Keywords: recurrent event, lifestyle, ischemic stroke, stroke, nomogram

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]