3.1 Baseline characteristics
A total of 1,041 patients were followed up in our study. The median age of the patients with regular follow-up at 1 year after discharge was 65.73 years, and the proportion of females was 35.7. The median age of patients with irregular follow-up was 68.01, and the proportion of females was 37.7. Additional general information is presented in Table 1.
Table 1 Descriptive statisticsa
Variables
|
follow-up
|
No
|
Yes
|
P-value
|
Age, mean (SD)
|
68.01 (11.45)
|
65.73 (11.71)
|
0.006
|
Sex=female, n (%)
|
101 (37.7)
|
277 (35.7)
|
0.609
|
Marital status, n (%)
|
|
|
0.449
|
Unmarried
|
2 (0.7)
|
7 ( 0.9)
|
Married
|
248 (92.5)
|
699 (90.1)
|
Widowed
|
14 (5.2)
|
62 (8.0)
|
Divorced
|
4 (1.5)
|
8 (1.0)
|
Insurance type, n (%)
|
|
|
<0.001
|
UEBMI
|
177 (66.0)
|
394 (50.8)
|
URBMI
|
67 (25.0)
|
225 (29.0)
|
NCMS
|
21 (7.8)
|
138 (17.8)
|
Self-payment
|
3 (1.1)
|
19 ( 2.4)
|
living with children = Yes, n (%)
|
129 (48.1)
|
414 (53.4)
|
0.161
|
hypertension = Yes, n (%)
|
173 (64.6)
|
551 (71.0)
|
0.058
|
diabetes = Yes, n (%)
|
112 (41.8)
|
314 (40.5)
|
0.757
|
hyperlipidemia = Yes, n (%)
|
145 (54.1)
|
506 (65.2)
|
0.002
|
N
|
268
|
776
|
|
Abbreviations: NCMS=New Cooperative Medical Scheme, SD=standard deviation, URBMI=Urban Residents Basic Medical Insurance, UEBMI=Urban Employment Basic Medical Insurance. aFor continuous variables, we used a t-test to estimate the P-value; for category variables, Fisher’s exact test was used.
[Table 1 here]
3.2 Patient's knowledge of their illness
There were 103, 19, and 45 patients diagnosed with diabetes, hypertension, and hyperlipidemia, respectively, who were unaware of their illness (Table 2).
Table 2. Patient's knowledge of their illness
|
Patient perception
|
Diagnosis of medical record
|
|
No
|
Yes
|
Diabetes
|
No
|
281
|
103
|
Yes
|
39
|
621
|
Hypertension
|
No
|
599
|
19
|
|
Yes
|
45
|
381
|
Hyperlipidemia
|
no
|
348
|
45
|
|
yes
|
92
|
559
|
3.3 Secondary prevention in patients with acute non-cardiogenic stroke 1 year after discharge
Regarding lifestyle, only 18.3% of patients with acute non-cardiogenic stroke combined with obesity lost weight. The proportion of patients with abstinence was 58.0%, 55.5% quit smoking, and less than 80% adhered to the three high levels of treatment and antithrombotic therapy (Table 3).
Table 3 Compliance with risk factor prevention
Variables
|
Compliance rate(%)
|
Alcohol abstinence
|
177/305 (58.0)
|
Low-salt diet
|
774/1041 (74.4)
|
Variety of dietary types
|
692/1041 (66.5)
|
Enhanced activity
|
730/1041 (70.1)
|
Weight loss
|
53/290 (18.3)
|
Hypoglycemic therapy
|
326/424 (76.9)
|
Antihypertensive therapy
|
566/723 (78.3)
|
Hypolipidemic therapy
|
483/650 (74.3)
|
Antiplatelet therapy
|
821/1041 (78.9)
|
Smoking cessation
|
213/384 (55.5)
|
Anticoagulant therapy
|
63/77 (81.8)
|
Note: Rates of smoking cessation, alcohol abstinence, and weight loss were calculated by dividing the number of people who quit smoking, abstained from alcohol, and lost weight by the number of those who smoked, drank, and were obese.
The adherence rates to treatment of hyperglycemia, hypertension, and hyperlipidemia were obtained by dividing the number of patients with hyperglycemia, hypertension, and hyperlipidemia by the number of those with hyperglycemia, hypertension, and hyperlipidemia.
3.4 Analysis of influencing factors on secondary prevention in patients with acute non-cardiogenic stroke 1 year after discharge
The results of the logistic regression with follow-up as the dependent variable are presented in Table 4. The older the patient, the less likely they were to accept treatment (Odds ratio [OR]=0.99, 95% confidence interval [CI)]: 0.97, 0.99). Furthermore, patients under the New Cooperative Medical Scheme (NCMS) are more likely to accept treatment than those with Urban Employment Basic Medical Insurance (UEBMI) (OR=2.19, 95% CI: 1.34, 3.74). Patients with hypertension (OR=1.51, 95% CI: 1.11, 2.06) or hyperlipidemia (OR=1.49, 95% CI: 1.10, 2.01) were more likely to accept treatment.
Table 4 Logistic regression results for follow-up variable
Variables
|
OR
|
95% CI
|
P-value
|
Intercept
|
5.33
|
(0.85, 47.13)
|
0.09
|
Age
|
0.99
|
(0.97, 0.99)
|
0.03
|
Sex (ref=male)
|
0.85
|
(0.62, 1.15)
|
0.28
|
Education level (ref= illiterate)
|
|
|
|
Elementary school or below
|
0.57
|
(0.36, 0.90)
|
0.02
|
Junior high school or above
|
0.49
|
(0.30, 0.80)
|
0.01
|
Marital status (ref= unmarried)
|
|
|
|
Married
|
1.23
|
(0.18, 5.54)
|
0.8
|
Widowed
|
2.07
|
(0.27, 10.72)
|
0.42
|
Divorced
|
0.88
|
(0.09, 6.56)
|
0.9
|
Insurance type (ref= UEBMI)
|
|
|
|
URBMI
|
1.26
|
(0.88, 1.81)
|
0.21
|
NCMS
|
2.19
|
(1.34, 3.74)
|
<0.001
|
Self-payment
|
1.75
|
(0.55, 7.84)
|
0.39
|
Living with children (ref=No)
|
1.11
|
(0.83, 1.49)
|
0.47
|
Hypertension (ref=No)
|
1.51
|
(1.11, 2.06)
|
0.01
|
Diabetes (ref=No)
|
1
|
(0.75, 1.34)
|
0.99
|
Hyperlipidemia (ref=No)
|
1.49
|
(1.1, 2.01)
|
0.01
|
Abbreviations: OR=Odds ratio; CI= Confidence interval; NCMS, new cooperative medical scheme; URBMI, urban residents’ basic medical insurance; UEBMI, urban employment basic medical insurance.
[Table 4 here]
3.5 Correlation analysis of secondary prevention in patients with acute non-cardiogenic stroke complicated with "hypertension, diabetes, and hyperlipidemia"
Figure 1 displays the ORs between patients with one or two of the three cardiovascular diseases (hypertension, diabetes, and hyperlipidemia) and those with all three. There were no statistically significant differences in the probability of treatment acceptance between patients experiencing one or two of the three cardiovascular diseases and those afflicted with all three, with treatment as the dependent variable (Fig 1a). There was no statistically significant differences in the probability of treatment acceptance between patients experiencing one or two of the three cardiovascular diseases and those afflicted with all three (Fig 1b), with follow-up as the dependent variable. The results align with those of Fig 1a.