医学
四分位数
内科学
入射(几何)
统计显著性
冲程(发动机)
死亡率
疾病
队列
置信区间
机械工程
光学
物理
工程类
作者
Wen-Jun Tu,Han-Cheng Qiu,Yi-Qun Zhang,Jianlei Cao,Hong Wang,Jizong Zhao,Qiang Liu,Xianwei Zeng
出处
期刊:Neurology
[Ovid Technologies (Wolters Kluwer)]
日期:2019-03-08
卷期号:92 (15): e1678-e1687
被引量:34
标识
DOI:10.1212/wnl.0000000000007261
摘要
Objective To explore the association between serum retinoic acid (RA) level in patients with acute ischemic stroke (AIS) and mortality risk in the 6 months after admission. Methods From January 2015 through December 2016, patients admitted to 3 stroke centers in China for first-ever AIS were screened. The primary endpoint was all-cause mortality or cardiovascular disease (CVD) mortality in the 6 months after admission. The significance of serum RA level, NIH Stroke Scale score, and established risk factors in predicting mortality were determined. The integrated discrimination improvement (IDI) and net reclassification improvement (NRI) statistics were applied in statistical analysis. Results Of the 1,530 patients enrolled, 325 died within 6 months of admission, with an all-cause mortality of 21.2% and CVD-related mortality of 13.1%. In multivariable analysis, RA levels were expressed as quartiles with the clinical variables. The results of the second to fourth quartiles (Q2–Q4) were compared with the first quartile (Q1); RA levels showed prognostic significance, with decreased all-cause and CVD mortality of 55% and 63%, respectively. After RA was added to the existing risk factors, all-cause mortality could be better reclassified, in association with only the NRI statistic ( p = 0.005); CVD mortality could be better reclassified with significance, in association with both the IDI and NRI statistics ( p < 0.01). Conclusions Low circulating levels of RA were associated with increased risk of all-cause and CVD mortality in a cohort of patients with first-incidence AIS, indicating that RA level could be a predictor independent of established conventional risk factors.
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