AI Chat Paper
Note: Please note that the following content is generated by AMiner AI. SciOpen does not take any responsibility related to this content.
{{lang === 'zh_CN' ? '文章概述' : 'Summary'}}
{{lang === 'en_US' ? '中' : 'Eng'}}
Chat more with AI
Powered by AMiner. Clicking this button will take you away from SciOpen.
Home Journal of Neurorestoratology Article
Article Link
Cite
EndNote(RIS) BibTeX
Collect
Submit Manuscript
Show Outline
Outline
Show full outline
Hide outline
Outline
Show full outline
Hide outline
Original Research | Open Access

Unveiling the antecedent configurations of cerebral infarction recurrence using qualitative comparative analysis

Department of Rehabilitation Medicine, Affiliated Hospital of Weifang Medical University, Weifang 261035, Shandong, China
School of Rehabilitation Medicine of Binzhou Medical University. GuanHai Road 346, Yantai 264003, Shandong, China
Department of Physiotherapy, Weigao Hospital, Gongsongling Road, Yiyuan Street, Weihai 264209, Shandong, China
Department of Rehabilitation Medicine, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai 264200, Shandong, China
Show Author Information

Abstract

Background

Ischemic stroke is characterized by high incidence, high disability rate, and high recurrence rate. Stroke recurrence is a complex pathological phenomenon involving multiple factors. Logistic regression analysis is widely used in traditional medical statistical analysis. However, this method mainly investigates the net effect of single factors using large sample sizes. The fsQCA method is a more suitable means of analyzing the configuration effect of risk factors affecting cerebral infarction recurrence, because it is based on holism and considers interaction effects among the risk factors.

Objective

The purpose of this study was to explore the risk factors of cerebral infarction recurrence using fsQCA, to reveal the configurations that resulted in cerebral infarction recurrence, and to provide novel ideas for the prevention of recurrence.

Methods

A total of 155 cerebral infarction patients admitted to the Department of Neurology of a tertiary class hospital in Shandong province from June 2020 to June 2021 were selected to participate. The demographic characteristics and risk factors associated with recurrence of cerebral infarction were collected, and participants were followed for one year.

Results

The comparative analysis was performed by fuzzy-set (fsQCA 3.0) software. We conducted a configuration analysis of the risk factors of cerebral infarction recurrence and generated eight different configurations by analyzing various combinations of eight risk factors.

Conclusion

This study presented results different from those reported in studies using linear regression models. It took into consideration the configurational effect of each conditional variable on cerebral infarction recurrence. To prevent such recurrences, medical workers should evaluate the combination of multiple influencing factors, instead of focusing on a single factor.

Keywords

ConfigurationFuzzy-set qualitative comparative analysis (fsQCA)Recurrence of cerebral infarctionPrevention path

References

1

Zhang CQ, Wang YL, Zhao XQ, et al. Prediction of recurrent stroke or transient ischemic attack after noncardiogenic posterior circulation ischemic stroke. Stroke. 2017;48(7):1835–1841. https://doi.org/10.1161/STROKEAHA.116.016285.
Crossref Google Scholar
2

Gu HQ, Yang X, Wang CJ, et al. Clinical characteristics, management, and In-hospital outcomes in patients with stroke or transient ischemic attack in China. JAMA Netw Open. 2021;4(8):e2120745. https://doi.org/10.1001/jamanetworkopen.2021.20745.
Crossref Google Scholar
3

Wang YL, Xu J, Zhao XQ, et al. Association of hypertension with stroke recurrence depends on ischemic stroke subtype. Stroke. 2013;44(5):1232–1237. https://doi.org/10.1161/STROKEAHA.111.000302.
Crossref Google Scholar
4

Pan YS, Li ZX, Li JJ, et al. Residual risk and its risk factors for ischemic stroke with adherence to guideline-based secondary stroke prevention. J Stroke. 2021;23(1):51–60. https://doi.org/10.5853/jos.2020.03391.
Crossref Google Scholar
5

Gynnild MN, Aakerøy R, Spigset O, et al. Vascular risk factor control and adherence to secondary preventive medication after ischaemic stroke. J Intern Med. 2021;289(3):355–368. https://doi.org/10.1111/joim.13161.
Crossref Google Scholar
6

Boehme AK, Esenwa C, Elkind MS. Stroke risk factors, genetics, and prevention. Circ Res. 2017;120(3):472–495. https://doi.org/10.1161/CIRCRESAHA.116. 308398.
Crossref Google Scholar
7

Sibbritt PD, Peng DW, Hosseini DM, et al. An examination of modifiable risk factors in stroke survivors, with a view to recurrent stroke prevention. J Stroke Cerebrovasc Dis. 2022;31(8):106547. https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106547.
Crossref Google Scholar
8

Wang YL, Zhao SQ, Zhao XQ, et al. Guidelines for the diagnosis and treatment of high-risk non-disabling ischemic cerebrovascular events (in Chinese). Chinese Journal of Stroke. 2016;11(6):481–491. https://doi.org/10.3969/j.issn.1673-5765.2016.06.011.
Crossref Google Scholar
9

Akpalu A, Sarfo FS, Akinyemi J, et al. Frequency & factors associated with recurrent stroke in Ghana and Nigeria. J Neurol Sci. 2022;439:120303. https://doi.org/10.1016/j.jns.2022.120303.
Crossref Google Scholar
10

Cheng JQ, Luo JL, Du YZ, et al. When institutional contexts and psychological cognition can stimulate entrepreneurship activity?: a study based on QCA approach (in Chinese). Sci Sci Manag S& T. 2019;40(2):114–131.
Google Scholar
11

Thomas J, O’Mara-Eves A, Brunton G. Using qualitative comparative analysis (QCA) in systematic reviews of complex interventions: a worked example. Syst Rev. 2014;3:67. https://doi.org/10.1186/2046-4053-3-67.
Crossref Google Scholar
12

Gao W, Gao J, Li JZ. Effect route of entrepreneurship policy on city entrepreneurship: a research based on fuzzy set qualitative comparative analysis (in Chinese). Technol Econ. 2018;37(4):68–75.
Google Scholar
13

Longest KC, Vaisey S. Fuzzy: a program for performing qualitative comparative analyses (QCA) in stata. STATA J. 2008;8(1):79–104. https://doi.org/10.1177/1536867X0800800106.
Crossref Google Scholar
14

Giménez-Espert MDC, Prado-Gascó VJ. The role of empathy and emotional intelligence in nurses' communication attitudes using regression models and fuzzy-set qualitative comparative analysis models. J Clin Nurs. 2018;27(13/14):2661–2672. https://doi.org/10.1111/jocn14325.
Crossref Google Scholar
15

Schneider MR, Schulze-Bentrop C, Paunescu M. Mapping the institutional capital of high-tech firms: a fuzzy-set analysis of capitalist variety and export performance. J Int Bus Stud. 2010;41(2):246–266. https://doi.org/10.1057/jibs.2009.36.
Crossref Google Scholar
16
Rihoux B, Ragin C. Configurational Comparative Methods: Qualitative Comparative|n Analysis (QCA) and Related Techniques[M]. 2455 Teller Road. Thousand Oaks California 91320. United States: SAGE Publications, Inc; 2009. https://doi.org/10.4135/9781452226569.
Crossref
17

Woodside AG. Moving beyond multiple regression analysis to algorithms: calling for adoption of a paradigm shift from symmetric to asymmetric thinking in data analysis and crafting theory. J Bus Res. 2013;66(4):463–472. https://doi.org/10.1016/j.jbusres.2012.12.021.
Crossref Google Scholar
18

Chen YP, Wright N, Guo Y, et al. Mortality and recurrent vascular events after first incident stroke: a 9-year community-based study of 0·5 million Chinese adults. Lancet Global Health. 2020;8(4):e580–e590. https://doi.org/10.1016/S2214-109X(20)30069-3.
Crossref Google Scholar
19

Wang PL, Wang YL, Zhao XQ, et al. In-hospital medical complications associated with stroke recurrence after initial ischemic stroke: a prospective cohort study from the China National Stroke Registry. Medicine. 2016;95(37):e4929. https://doi.org/10.1097/MD.0000000000004929.
Crossref Google Scholar
20
The International Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke. International Stroke Trial Collaborative Group. Lancet. 1997;349(9065):1569–1581. https://doi.org/10.1016/S0140-6736(97)04011-7.
Crossref
21
Cast Randomised placebo-controlled trial of early aspirin use in 20,000 patients with acute ischaemic stroke. CAST (Chinese Acute Stroke Trial) Collaborative Group. Lancet. 1997;349(9066):1641–1649. https://doi.org/10.1016/S0140-6736(97)04010-5.
Crossref
22

Schömig A, Neumann FJ, Kastrati A, et al. A randomized comparison of antiplatelet and anticoagulant therapy after the placement of coronary-artery stents. N Engl J Med. 1996;334(17):1084–1089. https://doi.org/10.1056/NEJM199604253341702.
Crossref Google Scholar
23

Liang Y, Ao X. Meta-analysis of risk factors of vascular cognitive disorder in acute cerebral infarction patients. Yangtze Med. 2020;4(2):97–113. https://doi.org/10.4236/ym.2020.42010.
Crossref Google Scholar
24

Rahman H, Khan SU, Nasir F, et al. Optimal duration of aspirin plus clopidogrel after ischemic stroke or transient ischemic attack. Stroke. 2019;50(4):947–953. https://doi.org/10.1161/STROKEAHA.118.023978.
Crossref Google Scholar
25

Kheiri B, Osman M, Abdalla A, et al. Clopidogrel and aspirin after ischemic stroke or transient ischemic attack: an updated systematic review and meta-analysis of randomized clinical trials. J Thromb Thrombolysis. 2019;47(2):233–247. https://doi.org/10.1007/s11239-018-1786-z.
Crossref Google Scholar
26

Kennedy J, Hill MD, Ryckborst KJ, et al. Fast assessment of stroke and transient ischaemic attack to prevent early recurrence (FASTER): a randomised controlled pilot trial. Lancet Neurol. 2007;6(11):961–969. https://doi.org/10.1016/S1474-4422(07)70250-8.
Crossref Google Scholar
27

Song PG, Fang Z, Wang HY, et al. Global and regional prevalence, burden, and risk factors for carotid atherosclerosis: a systematic review, meta-analysis, and modelling study. Lancet Global Health. 2020;8(5):e721–e729. https://doi.org/10.1016/S2214-109X(20)30117-0.
Crossref Google Scholar
28

Huang YC, Lee JD, Weng HH, et al. Statin and dual antiplatelet therapy for the prevention of early neurological deterioration and recurrent stroke in branch atheromatous disease: a protocol for a prospective single-arm study using a historical control for comparison. BMJ Open. 2021;11(11):e054381. https://doi.org/10.1136/bmjopen-2021-054381.
Crossref Google Scholar
29

Zheng SB, Yao BD. Impact of risk factors for recurrence after the first ischemic stroke in adults: a systematic review and meta-analysis. J Clin Neurosci. 2019;60:24–30. https://doi.org/10.1016/j.jocn.2018.10.026.
Crossref Google Scholar
30

Penado S, Cano M, Acha O, et al. Atrial fibrillation as a risk factor for stroke recurrence. Am J Med. 2003;114(3):206–210. https://doi.org/10.1016/s0002-9343(02)01479-1.
Crossref Google Scholar
31

Mohan KM, Crichton SL, Grieve AP, et al. Frequency and predictors for the risk of stroke recurrence up to 10 years after stroke: the South London Stroke Register. J Neurol Neurosurg Psychiatry. 2009;80(9):1012–1018. https://doi.org/10.1136/jnnp.2008.170456.
Crossref Google Scholar
32

Wu SM, Wu B, Liu M, et al. Stroke in China: advances and challenges in epidemiology, prevention, and management. Lancet Neurol. 2019;18(4):394–405. https://doi.org/10.1016/S1474-4422(18)30500-3.
Crossref Google Scholar
33

Wang YW, Wang Y, Du L, et al. Risk factors, recurrence and short-term outcomes for progressive cerebral infarction: a retrospective study. Neurol India. 2021;69(6):1675–1681. https://doi.org/10.4103/0028-3886.333493.
Crossref Google Scholar
34

Norrving B, Kissela B. The global burden of stroke and need for a continuum of care. Neurology. 2013;80(3 suppl 2):S5–S12. https://doi.org/10.1212/WNL.0b013e3182762397.
Crossref Google Scholar
35

Omori T, Kawagoe M, Moriyama M, et al. Multifactorial analysis of factors affecting recurrence of stroke in Japan. Asia Pac J Public Health. 2015;27(2):NP333–NP340. https://doi.org/10.1177/1010539512441821.
Crossref Google Scholar
36

Phan HT, Gall S, Blizzard CL, et al. Sex differences in causes of death after stroke: evidence from a national, prospective registry. J Womens Health (Larchmt). 2021;30(3):314–323. https://doi.org/10.1089/jwh.2020.8391.
Crossref Google Scholar
37

Qiao Q, Hong Y, Zhao W, et al. Sex differences in outcomes and associated factors among stroke patients with small artery occlusion in China. Biol Sex Differ. 2018;9(1):35. https://doi.org/10.1186/s13293-018-0194-6.
Crossref Google Scholar
38

Kocaman G, Dürüyen H, Koçer A, et al. Recurrent ischemic stroke characteristics and assessment of sufficiency of secondary stroke prevention. Noro Psikiyatr Ars. 2015;52(2):139–144. https://doi.org/10.5152/npa.2015.7499.
Crossref Google Scholar
39

Jain S, Namboodri KK, Kumari S, et al. Loss of circadian rhythm of blood pressure following acute stroke. BMC Neurol. 2004;4:1. https://doi.org/10.1186/1471-2377-4-1.
Crossref Google Scholar
40

Zhao ML, Zhang LZ, Wang ZY, et al. Dynamic analysis of blood pressure changes in progressive cerebral infarction. Int Health. 2015;7(4):293–297. https://doi.org/10.1093/inthealth/ihu087.
Crossref Google Scholar
41

Muir KW, Weir CJ, Murray GD, et al. Comparison of neurological scales and scoring systems for acute stroke prognosis. Stroke. 1996;27(10):1817–1820. https://doi.org/10.1161/01.str.27.10.1817.
Crossref Google Scholar
42

Zhao XJ, Li QX, Liu TJ, et al. Predictive values of CSS and NIHSS in the prognosis of patients with acute cerebral infarction: a comparative analysis. Medicine. 2018;97(39):e12419. https://doi.org/10.1097/MD.0000000000012419.
Crossref Google Scholar
Journal of Neurorestoratology
Volume 12 Issue 1,
March 2024
Article number: 100091
DOI: 10.1016/j.jnrt.2023.100091
Cite this article:
Li Y, Wu D, Wang A, et al. Unveiling the antecedent configurations of cerebral infarction recurrence using qualitative comparative analysis. Journal of Neurorestoratology, 2024, 12(1): 100091. https://doi.org/10.1016/j.jnrt.2023.100091

235

Views

1

Crossref

2

Web of Science

2

Scopus

Altmetrics
Received: 28 June 2023
Revised: 02 November 2023
Accepted: 08 November 2023
Published: 05 December 2023
© 2023 The Authors.

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Return