Analysis of Influencing Factors for Post-stroke Cognitive Impairment in Stroke Patients

CHEN Chunyan; WU Xiangbo; HAN Tao; LIN Xiaodong; LIANG Hongling; DENG Kaifang; YUAN Hua; SUN Xiaolong; ZHAO Hangkun

doi:10.13730/j.issn.2097-2148.2025.11.008

Abstract：Objective To explore the influencing factors of post-stroke cognitive impairment(PSCI)in stroke patients,and provide reference for clinical prevention and treatment.Methods A retrospective analysis was performed on a cohort of 404 stroke patients admitted to the department of rehabilitation medicine of the author's hospital from January 2019 to March 2024,the patients were categorized into PSCI group(n=201)and non-PSCI group(n=203)based on their mini-mental state examina-tion(MMSE)scores at the time of admission.The national institute of health stroke scale(NIHSS)was used to evaluate the se-verity of neurological deficit in stroke patients.The modified Barthel index(MBI)was used to evaluate the cognitive function of stroke patients.The general data,disease-related data,comorbidities and complications of the patients in two groups were com-pared,multivariate Logistic regression analysis was used to explore the influencing factors of PSCI in stroke patients.Results Among the 404 patients,201(49.75％)developed PSCI.Compared to the non-PSCI group,patients in the PSCI group were ol-der,had higher NIHSS scores,and exhibited higher prevalence rates of hypoproteinemia,deep vein thrombosis and atrial fibrilla-tion,in contrast,the MBI scores and disease duration were significantly lower in the PSCI group(all P＜0.05);and statistical-ly significant differences were also observed between the two groups in blood type and stroke side(all P＜0.05).Multivariate Logistic regression analysis showed that age[odds ratio(OR)=1.022,95％confidence interval(CI):1.002-1.042],blood type(type B,OR=4.363,95％CI:1.951-9.759;type AB,OR=6.995,95％CI:3.133-15.627),high NIHSS score(OR=1.124,95％CI:1.074-1.176),stroke side(left side,OR=6.714,95％CI:3.670-12.283;bilateral,(OR=2.310,95％CI:1.087-4.909)and hypoproteinemia(OR=1.979,95％CI:1.013-3.865)were in-dependent risk factors for PSCI in stroke patients(all P＜0.05),high MBI score(OR=0.973,95％CI:0.960-0.986)was a protective factor(P＜0.001).Conclusion Age,blood type,NIHSS score,MBI score,laterality of the stroke and hypopro-teinemia are independent determinants influencing the development of PSCI,clinically,it is imperative to formulate personalized prevention and treatment strategies grounded in these determinants to mitigate the incidence of PSCI and enhance the quality of life for patients.