Background

Stroke is still the main cause of death and disability worldwide, numerous studies of recurrence risk have been reported, while systematic estimates of stroke recurrence risk in the last 10 years are variable. This review aims to estimate the cumulative stroke recurrence risk in the last 10 years for secondary prevention management in future.

Methods

A systematic search from January 2009 to March 2019 was conducted through PubMed, EMBASE, Web of Science, Wan-fang, and CNKI. Search terms were in English and Chinese.

Results

A total of 37 studies involving 1,075,014 stroke patients were included. The pooled stroke recurrence rate was 7.7% at 3 months, 9.5% at 6 months, 10.4% at 1 year, 16.1% at 2 years, 16.7% at 3 years, 14.8% at 5 years, 12.9% at 10 years, and 39.7% at 12 years after the initial stroke. In addition, the pooled recurrence rate of 32 studies including stroke patients over 50 years only at seven time points except for subgroup of 10 years was 7.7%, 9.5%, 11.2%, 16.1%, 19.3%, 18.1%, and 39.7%, respectively. Meta-regression showed that the time points explained 23.02% of the variance among studies, while regions, age, and stroke types showed no significant contribution to heterogeneity.

Conclusions

The risk of stroke recurrence varies greatly from 3 months to over 10 years and increases significantly over time in both young and old subgroup. The heterogeneity may be explained by follow-up time, regions, age, methodology differences, and stroke types, which was needed further exploration in future.

中文翻译：

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过去 10 年中风复发的累积风险：系统评价和荟萃分析

背景

中风仍然是全世界死亡和残疾的主要原因，已经报道了许多关于复发风险的研究，而对过去 10 年中风复发风险的系统估计是可变的。本综述旨在估计过去 10 年的累积卒中复发风险，以用于未来的二级预防管理。

方法

2009 年 1 月至 2019 年 3 月通过 PubMed、EMBASE、Web of Science、万方和 CNKI 进行系统检索。搜索词是英文和中文的。

结果

共纳入 37 项研究，涉及 1,075,014 名卒中患者。合并卒中复发率为 3 个月 7.7%、6 个月 9.5%、1 年 10.4%、2 年 16.1%、3 年 16.7%、5 年 14.8%、10 年 12.9% 和 39.7 % 在初次中风后 12 年。此外，包括 50 年以上卒中患者在内的 32 项研究的汇总复发率仅在 7 个时间点（10 年亚组除外）分别为 7.7%、9.5%、11.2%、16.1%、19.3%、18.1% 和 39.7%，分别。元回归显示，时间点解释了研究间 23.02% 的差异，而地区、年龄和卒中类型对异质性没有显着贡献。

结论

中风复发的风险从 3 个月到 10 年以上变化很大，并且随着时间的推移在年轻和老年亚组中显着增加。异质性可以通过随访时间、地区、年龄、方法学差异和卒中类型来解释，未来需要进一步探索。