NGHIÊN CỨU TỈ LỆ VÀ CÁC YẾU TỐ NGUY CƠ CỦA NHỒI MÁU NÃO TÁI DIỄN TẠI BỆNH VIỆN ĐA KHOA TRUNG ƯƠNG CẦN THƠ

Abstract

Background: Recurrent ischemic stroke (RIS) is a severe event that significantly increases the risk of mortality and disability. Identifying its rate and related factors is essential to improve treatment outcomes and secondary prevention. Objective: To determine the rate, etiological classification, and risk factors associated with recurrent ischemic stroke within 12 months after the first episode among patients treated at Can Tho Central General Hospital during the period 2022–2024. Methods: A prospective cohort study was conducted on 890 patients with ischemic stroke, each followed up for at least 12 months. Results: The 12-month recurrence rate was 6.7%. The cumulative recurrence rates were 2% at 1 month, 3.6% at 6 months, and 6.7% at 12 months. According to the TOAST classification, recurrence was most frequent in the large-artery atherosclerosis (LAA) group (38.2%) and cardioembolic (CE) group (24.7%), and least common in small-vessel disease (SVD) (21.3%). Cox regression analysis identified independent risk factors, including age ≥65 years, hypertension, diabetes mellitus and discontinuation of anticoagulant or antiplatelet therapy. Conclusion: The recurrence rate of ischemic stroke at Can Tho Central General Hospital (6.7%) was comparable to international data (5–7%). The highest recurrence risk was observed in the LAA and CE subtypes, particularly among patients who discontinued anticoagulant or antiplatelet therapy.