TY  - THES
T1  - Factors associated with recurrence of non cardioembolic ischemic strokes among Filipino patients a case control study
A1  - Collantes, Maria Epifania V.
LA  - English
UL  - https://ds.mainlib.upd.edu.ph/Record/UP-1685523046126182328
AB  - Stroke as devastating effect among the survivors. Stroke recurrence has even greater impact.  Despite the proven benefits and broad use of specific therapies, the incidence of recurrent ischemic events and mortality rate remain high.  It is important to identify the characteristics of people at high risk of recurrence.  This has important implications for planning secondary prevention strategies to reduce the disease burden. Identifying factors associated with stroke recurrence among Filipinos are needed to enable practitioners to make better clinical decisions. Research Question:  Among hospitalized, adult Filipino patients with first-ever noncardioembolic ischemic strokes on aspirin, what are the factors associated with stroke recurrence? General Objective: To determine the factors associated with stroke recurrence among Filipino patients with noncardioembolic strokes.  Specific Objectives:  1) To determine the strength of association between stroke recurrence and the following risk factors: hypertension, diabetes, TIA, heart disease, dyslipidemia, smoking, intracranial stenosis, alcoholism, control of BP and sugar, cessation of smoking, control of alcohol intake and compliance to aspirin. 2) To characterize stroke recurrence according to the timing and types of stroke. Methodology: This is a hospital-based case control study using the records from the PGH Stroke Data Bank. Inclusion criteria for stroke cases are as follows: 1) patients with first-ever noncardioembolic strokes admitted at PGH Neurology service. 2) index stroke during year 2000, 3) prescribed aspirin 3) admitted for stroke recurrence within 5 years from index stroke.  Controls were patients with 1) first-ever noncardioembolic strokes admitted at PGH Neurology service from January 2000-January 2005, 2) prescribed aspirin with 3) no clinical recurrence of stroke within 5 years from the index stroke evaluated on OPD follow-up.  Cases were matched with the controls according to age and sex in a 1:2 ratio. The following variables were evaluated: socio-demographic data, co morbid and lifestyle factors; Interval control of risk factors and outcomes measured by modified MRS. Results: Lifestyle modifications are protective factors for stroke recurrence. Among the cases, disability was greater in the second strokes compared with the index strokes. Among the cases, 88% had poor functional outcome (MRS >2) with the second stroke compared with index stroke (42%). The mortality rate for patients with stroke recurrence is 18% and 11% for those with no stroke recurrence.  Conclusion:  Control of blood pressure to SBP <120 and blood sugar control to HBAic<6 are protective factors for secondary stroke prevention. Stroke patients with diabetes, heart disease, alcohol intake >200gms/week and cryptogenic stroke have increased odds of stroke recurrence.  Frequency of stroke recurrence is highest 5 years from index stroke and the earliest was noted within 3 months post stroke.  Majority of the stroke recurrence among patients with noncardioembolic strokes are ischemic strokes. Patients with stroke recurrence have greater disability and mortality.
NO  - Theses--(MS in Clinical Epidemiology) University of the Philippines Manila
CN  - LG 995 2010 E6 C65
KW  - Cerebrovascular disease--Prevention.
KW  - Stroke.
ER  -