目的:中风死亡率在墨西哥等低收入和中等收入国家更为常见。预后数据通常依赖于短期医院随访,揭示了由于全身并发症和早期复发导致的高死亡率。我们旨在通过检查全因死亡率和特定原因死亡率来探讨卒中的长期影响。
方法:我们分析了墨西哥城前瞻性研究(1998-2004)的数据,已知死亡率结果直至2022年12月。比较卒中参与者和非卒中参与者的基线变量。Cox比例风险回归评估了每个变量对总死亡率的贡献。卒中亚组的后续分析旨在确定死亡的独特危险因素,使用根据年龄调整的Cox回归模型,性别,和中风后的时间。
结果:在145,537名合格参与者中,1,492(1.0%)有中风史。中风的参与者年龄较大(57.58vs50.16,p<0.001);每周平均收入较低(108.24美元vs176.14美元,p<0.001);饮酒和吸烟频率较高;合并症如高血压(48.9vs19.3%,p<0.001),糖尿病(23.4vs12.9%,p<0.001),和缺血性心脏病(5.4vs1.0%,p<0.001)。他们因任何原因死亡的风险显着增加(风险比[HR]2.59,95%CI2.37-2.83,p<0.001)。中风死亡的参与者更有可能是男性,糖尿病患病率较高,高血压,腰臀指数异常.卒中增加心源性死亡的风险(HR3.56,95%CI3.02-4.19,p<0.001),肾(HR2.05,95%CI1.58-2.66,p<0.001),和肺原因(HR2.29,95%CI1.79-2.92,p<0.001)。
结论:本研究证实卒中与较高的死亡率有关,尤其是来自心脏,肾,以及墨西哥的肺部原因。它强调了中风和有中风史死亡的参与者中心血管合并症和不良社会经济状况的患病率升高。
OBJECTIVE: Stroke mortality is more common in low-income and middle-income nations such as Mexico. Prognosis data typically rely on short-term hospital follow-ups, revealing high mortality rates due to systemic complications and early recurrence. We aim to explore stroke\'s long-term impact by examining all-cause and cause-specific mortality.
METHODS: We analyzed data from the Mexico City Prospective Study (1998-2004) with known mortality outcomes until December 2022. Baseline variables were compared between participants who had stroke and nonstroke participants. Cox proportional hazard regression assessed each variable\'s contribution to overall mortality. Subsequent analysis within the stroke subgroup aimed to identify unique risk factors of mortality, using Cox regression models adjusted for age, sex, and time since stroke.
RESULTS: Among 145,537 eligible participants, 1,492 (1.0%) had a history of stroke. Participants who had stroke were older (57.58 vs 50.16, p < 0.001); had lower mean weekly income ($108.24 vs $176.14, p < 0.001); had higher alcohol intake and smoking frequency; and had more frequent comorbidities such as hypertension (48.9 vs 19.3%, p < 0.001), diabetes (23.4 vs 12.9%, p < 0.001), and ischemic heart disease (5.4 vs 1.0%, p < 0.001). They had a significantly increased risk of death from any cause (hazard ratio [HR] 2.59, 95% CI 2.37-2.83, p < 0.001). Deceased participants with stroke were more likely to be male, with a higher prevalence of diabetes, hypertension, and abnormal waist-hip index. Stroke increased the risk of death from cardiac (HR 3.56, 95% CI 3.02-4.19, p < 0.001), renal (HR 2.05, 95% CI 1.58-2.66, p < 0.001), and pulmonary (HR 2.29, 95% CI 1.79-2.92, p < 0.001) causes.
CONCLUSIONS: This study confirms stroke\'s association with higher mortality rates, especially from cardiac, renal, and pulmonary causes in Mexico. It underscores the elevated prevalence of cardiovascular comorbidities and adverse socioeconomic profiles among participants who had stroke and those who died with a history of stroke.