Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Modeling Survival in Patients With Brain Stroke in the Presence of Competing Risks

  • Norouzi, Solmaz (Department of Statistics and Epidemiology, Faculty of Medicine, Zanjan University of Medical Sciences) ;
  • Jafarabadi, Mohammad Asghari (Department of Statistics and Epidemiology and Road Traffic Injury Research Center, Faculty of Health, Tabriz University of Medical Sciences) ;
  • Shamshirgaran, Seyed Morteza (Department of Statistics and Epidemiology, Faculty of Health Sciences, Neyshabur University of Medical Sciences) ;
  • Farzipoor, Farshid (Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences) ;
  • Fallah, Ramazan (Department of Statistics and Epidemiology, Faculty of Medicine, Zanjan University of Medical Sciences)
  • Received : 2020.09.20
  • Accepted : 2020.12.04
  • Published : 2021.01.31
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Abstract

Objectives: After heart disease, brain stroke (BS) is the second most common cause of death worldwide, underscoring the importance of understanding preventable and treatable risk factors for the outcomes of BS. This study aimed to model the survival of patients with BS in the presence of competing risks. Methods: This longitudinal study was conducted on 332 patients with a definitive diagnosis of BS. Demographic characteristics and risk factors were collected by a validated checklist. Patients' mortality status was investigated by telephone follow-up to identify deaths that may be have been caused by stroke or other factors (heart disease, diabetes, high cholesterol, etc.). Data were analyzed by the Lunn-McNeil approach at alpha=0.1. Results: Older age at diagnosis (59-68 years: adjusted hazard ratio [aHR], 2.19; 90% confidence interval [CI], 1.38 to 3.48; 69-75 years: aHR, 5.04; 90% CI, 3.25 to 7.80; ≥76 years: aHR, 5.30; 90% CI, 3.40 to 8.44), having heart disease (aHR, 1.65; 90% CI, 1.23 to 2.23), oral contraceptive pill use (women only) (aHR, 0.44; 90% CI, 0.24 to 0.78) and ischemic stroke (aHR, 0.52; 90% CI, 0.36 to 0.74) were directly related to death from BS. Older age at diagnosis (59-68 years: aHR, 21.42; 90% CI, 3.52 to 130.39; 75-69 years: aHR, 16.48; 90% CI, 2.75 to 98.69; ≥76 years: aHR, 26.03; 90% CI, 4.06 to 166.93) and rural residence (aHR, 2.30; 90% CI, 1.15 to 4.60) were directly related to death from other causes. Significant risk factors were found for both causes of death. Conclusions: BS-specific and non-BS-specific mortality had different risk factors. These findings could be utilized to prescribe optimal and specific treatment.

Keywords

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