The Study Of Secondary Prevention With Atherosclerotic Cerebral Infarction Patients

Purposes:The effect of discharge prescription on the prognosis and compliance of patients with atherosclerotic cerebral infarction (ACI).Methods:Retrospective collected the data of patients with cerebral infarction in our hospital from July 2012 to April 2015. Register their name, age, smoking history, drinking history, comorbidities, degree of intracranial and extra cranial artery stenosis, stroke subtype, discharge diagnosis,,discharge medication (mainly anti platelet drugs, statins and antihypertensive and hypoglycemic drugs), telephone number. Patients were followed up by telephone and recorded the drug that the patient is taking now, whether the cerebral infarction recrudescence after discharge, if it happens, and the time interval between recurrence and discharge. Analysis on the factors of patients adherence to medication and non adherence. And the effect of discharge prescription on medication compliance of patients. By using the SPSS 17.0 statistical standard software to analysis the statistical differences in risk factors.Results:Finally 813 patients with cerebral infarction were included. They were divided into adherence to the medication group (459,56.5%) and adherence to the medication group (354,43.5%). The risk of the recurrence of stroke was higher in non adherence group than adherence group. Adhere to medication may be associated with hypertension, and MRS≥3 points (P< 0.05). Persist in 165 cases (36.9%) of the patients with large artery atherosclerosis in the adherence group,294 patients (64.1%) with small artery occlusion. Persist in 84 cases (23.7%) of the patients with large artery atherosclerosis in the adherence group,270 patients (76.3%) with small artery occlusion, there were statistically significant differences between the two groups on the stroke type. Discharge prescriptions were divided into 3 groups:anti platelet drug or statin group:80 cases,42 patients (52.5%) had a compliance with the prescription, anti platelet and statin:651 cases,387 patients (59.4%) had a compliance, without anti platelet drugs and (or) statin drug group:82 cases,47 patients (57.3%) had a compliance with the prescription. A total of 47 cases (57.3%) were retaking drugs in the discharge prescription with none of the anti platelet drugs or statin drugs. It can indicate that patients are willing to take medication to control diseases. The patients who take one of the anti platelet drugs and statins drugs had the higher risk of recurrence than the patients in the simultaneous use of anti platelet agents and statins. Under the premise of using anti platelet agents and statins, recurrence occurred more in patients who did not take the drug of the corresponding complications. Risk of stroke recurrence in patients with stroke in the non neurological department was higher than that in the neurological department (P< 0.05, OR=0.291,95%CI,0.167-0.507).Conclusions:(a) Adherence to medication is related with the discharge prescriptions, complications (hypertension), the number of recurrence and the mRS score, also affected the prognosis of patients. (b) The standard of discharge prescriptions can influence the prognosis of patients. (c) When using the drug of secondary prevention, we should pay attention to the treatment of complications.