Study of the Factors Influencing Mortality from the Cerebral Stroke in Patients of Different Ages

Abstract

Aims: To detect significant relationships between risk factors of cerebral stroke and the age of patients. Identify a number of exogenous factors among the geoheliomagnetic and meteorological ones which have a significant impact on the increase in the fatal outcome probability. Study Design: Main research field: cerebral strokes. Place and Duration of Study: The research is based on the results of retrospective analysis of the autopsy of people who died of cerebral stroke according to the data of the N.A. Semashko Municipal Hospital No 1 (Central Municipal Hospital) of Rostov-on-Don, Russia during the years of high (2000-2002) and low (2008-2010) solar activity. Methodology: The study involves 1135 patients who died of cerebral stroke. 5 observation groups were formed depending on the age: 1 group: 34 (3%) – less than 45 years old; 2 group: 200 (17.6%) - between 45-59 years old; 3 group: 540 (47.6%) - between 60-74 years old; 4 group: 356 (31.4%) - between 75-89 years old; 5 group: 5 (0.4%) - 90 and more years old. Nosological signs of disease and endogenous risk factors were recorded for each observation. To evaluate the complex impact of the environmental factors on the death rate of the vascular accidents, 44 exogenous risk factors were analyzed. Results: With the help of multivariate logistic regression method, after the construction of a mathematical model, nine endogenous and 8 exogenous factors, from amount participating in the analysis, which can be factors of immediate death risk for the patients belonging to various age groups, were detected. The coincidence of fact and calculations according to the gradations of the classification variable containing the meaning of number of age group, is ensured in 68.2% of cases (Concordant),coefficient of association Somers’D: .371. Model quality was evaluated according to the modeling sample. It is statistically proved, that death occurred with the patients of young and middle age because of diseases associated with hypertension, atherosclerosis of the 2-3 stage, alcohol. Characteristic CS type – hemorrhagic, especially hematoma class with blood breakthrough into the brain ventricles. Severe course of disease with frequent deaths in the 1st day are typical. In case of established combination of the pathogenic effect is mostly associated with high solar and geomagnetic activity. Among the patients of the elderly and the senile age appeared patients with secondary arterial hypertension, atherosclerosis of the 3-4 stage, heart diseases in the form of ciliary arrhythmia and coronary heart disease. Characteristic CS type – ischemic, especially non-atherothrombotic class. Death during the 1st day was statistically less likely. The maximum meteotropic reactions occur with contrasting weather patterns change, quick change of air masses with different thermal properties. Conclusion: Data about the discovered specific risk factors for the patients of different ages would allow choosing a more efficient individual approach to each patient aimed at improving the effectiveness of treatment and reducing the frequency of fatal outcomes.