Characteristics of acute ischemic stroke in hospitalized patients in Tibet: a retrospective comparative study

BMC Neurology

Feiqi Zhu¹  Jun Xu²  Yuxuan Lu³  Jingjing Luo³  Yongan Sun³  Haiqiang Jin³  Yuhua Zhao⁴  Shihua He⁴  Zhijie Ding⁴  Cidan Zhuoga⁴  Ailian Du⁵ 

[1] Cognitive Impairment Ward of Neurology Department, The Third Affiliated Hospital of Shenzhen University Medical College, 518005, Shenzhen, China;Department of Cognitive Neurology, China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing Tiantan Hospital, Capital Medical University, 100070, Beijing, China;Department of Neurology, Peking University First Hospital, No. 8, Xishiku St, Xicheng District, 100034, Beijing, China;Department of Neurology, People’s Hospital of Tibet Autonomous Region, 850000, Lhasa, Tibet, China;Department of Neurology, Tongren Hospital, Shanghai Jiaotong University School of Medicine, 200050, Shanghai, China;

关键词: High altitude;    Acute ischemic stroke;    Risk factor;    Stroke subtype;    Young adult stroke;   

DOI  :  10.1186/s12883-020-01957-0

来源: Springer

【 摘 要 】

BackgroundNumerous studies on acute ischemic stroke (AIS) have been conducted at low-altitude regions, and the related findings have been used to guide clinical management. However, corresponding studies at high altitude are few. This study aimed to analyse the clinical characteristics of AIS patients at high-altitude regions through a hospital-based comparative study between Tibet and Beijing.MethodsThis study included the diagnoses of AIS patients from People’s Hospital of Tibet Autonomous Region (PHOTAR) and Peking University First Hospital (PUFH) between 1 January 2014 and 31 December 2017, where data including patient demographics, treatment time, onset season, risk factors, infarction location, laboratory data, image examination results, treatments, and AIS subtype were collected and compared. Continuous and categorical variables were analysed with a two-sample t-test or Wilcoxon rank sum test and chi-square test, respectively. Significant risk factors were examined with binary logistic regression analysis.ResultsIn total, 236 and 1021 inpatients from PHOTAR and PUFH were included, respectively. The PHOTAR patients were younger than the PUFH patients (P < 0.001). Young adult stroke, erythrocytosis, and hyperhomocysteinemia were more frequent in PHOTAR patients (all P < 0.001). Other vascular risk factors, including hypertension, diabetes mellitus, hyperlipidaemia, smoking and alcohol consumption history, were less prevalent in PHOTAR patients than in PUFH patients. The rate of intravenous thrombolysis and the rate of within intravenous thrombolysis window time were also lower in PHOTAR patients (both P < 0.001). The PHOTAR group also tended to have anterior circulation infarction. Erythrocytosis and hyperhomocysteinemia were independent risk factors in PHOTAR, and young adults accounted for a larger proportion of stroke cases.ConclusionIn Tibet, AIS patients were relatively younger, and anterior circulation infarctions were more common. Erythrocytosis and hyperhomocysteinemia may contribute to these differences. Here, young adult stroke also accounted for a higher proportion, and this may be associated with erythrocytosis. Our findings present the first hospital-based comparative study in Tibet and may contribute to policies for stroke prevention in this region.

【 授权许可】

CC BY