Epidemiology and Characteristics of Recurrent Stroke: The Occurrence Type of Restroke is Similar as Previous Stroke

Ok, Young Cheol; Park, Seung Kyu; Cho, Kyu Yong; Lim, Jun Seob; Lee, Rae Seop

Abstract

OBJECTIVE
Despite improvement of therapeutic regimen, incidence of stroke increases and it remains a leading cause of death. Our study aims at offering variable data on recurrent strokes.
METHODS
There were 59 patients who admitted from Jan. 2002 to Dec. 2004 due to recurrent strokes. A retrospective longitudinal cohort study was done.
RESULTS
Four-hundred-seventy five patients, diagnosed with acute stroke, experienced 491 strokes in 3 years, and there were 75 recurrent strokes (15.3%) in 59 patients. These 59 patients were included in the study. First hemorrhagic cases (H) were 19 (32%), and the first infarction cases (I) were 40 (68%). Subsequent strokes after first stroke were as follows : H-->H 14 (23.7%)cases, H-->I 5 (8.5%), I-->H 8 (13.6%), I-->I 32 (54.2%). A Cox regression analyses showed that the first type of stroke was a significant factor to the second stroke as follows : if one has had a hemorrhagic stroke, the possibility of second hemorrhagic attack (H-->H attack) increase 3.2 times than ischemic type and in ischemic stroke (I-->I attack) 3.6 times increased incidence of second ischemic attack.
CONCLUSION
The recurrence rate of stroke was 12.4% (59 of 475 patients). If the first stroke is hemorrhage or infarction, the next stroke would have high potentiality of hemorrhage, or infarction. The possibility of same type in second stroke increase over 3 times. In H-->H group, the time interval between first and second stroke was shorter and the age of onset was earlier than in I-->I group. Moreover, the infarction was more frequent than hemorrhage in multiple strokes. There was a correlation in lacunar type infarction between first and second attack.