Factors Associated with Recurrent Stroke in Patients Treated At Thasala Hospital, Nakhon Si Thammarat Province.
Keywords:
Ischemic stroke, Recurrence, ADL, Diabetes Mellitus Screening Model, atrial fibrillationAbstract
Stroke is a major public health problem in Thailand, particularly recurrent stroke, which negatively impacts quality of life and healthcare costs. This study aimed to investigate factors associated with recurrence, focusing on clinical factors, laboratory findings, and patients' ability to perform activities of daily living.
Objective: To determine factors associated with recurrent stroke among patients treated to Thasala Hospital, Nakhon Si Thammarat Province.
Methods: A descriptive cross-sectional study was conducted using secondary data from medical records of 1,721 stroke patients between 2021 and 2024. The research instrument was a structured data extraction form developed by the investigators, which included demographic variables (age, sex, employment status), clinical information (comorbidities, blood pressure, laboratory values including LDL, HDL, triglycerides, and ADL score), and outcomes (recurrence, mortality). Data were analyzed using independent t-test, chi-square test, and Fisher’s exact test. Multivariate logistic regression was employed to identify associated factors, with statistical significance set at p < 0.05.
Results: The recurrence rate was 39.5%. Factors significantly associated with recurrence included age > 65 years (Adjusted OR = 1.52, 95% CI: 1.25–1.85, p < 0.001), diabetes mellitus (Adjusted OR = 1.39, 95% CI: 1.13–1.70, p = 0.002), and atrial fibrillation (Adjusted OR = 2.10, 95% CI: 1.27–3.48, p = 0.048). Laboratory findings showed that LDL ≥ 130 mg/dL increased the risk (Adjusted OR = 1.45, 95% CI: 1.17–1.80, p = 0.005). Functional assessment revealed that patients with ADL score ≤ 8 had a significantly higher likelihood of recurrence (Adjusted OR = 2.10, 95% CI: 1.67–2.63, p < 0.001).
Conclusion: The incidence of stroke recurrence was associated with age, diabetes mellitus, atrial fibrillation (AF), blood lipid levels, and functional independence based on ADL score. These findings highlight the importance of continuous monitoring of stroke patients, particularly those with low ADL scores and hyperlipidemia, to prevent recurrence. Post-stroke rehabilitation programs should be implemented to promote self-reliance and reduce the likelihood of future recurrence. This information can be used as a guideline for screening high-risk patients and planning preventive care effectively in community hospitals.
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