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Review
. 2023 Feb 22;9(3):e13949.
doi: 10.1016/j.heliyon.2023.e13949. eCollection 2023 Mar.

Lifestyle, clinical, and occupational risk factors of recurrent stroke among the working-age group: A systematic review and meta-analysis

Araya Chiangkhong  1 , Charin Suwanwong  2 , Yupha Wongrostrai  1
Affiliations
Review

Lifestyle, clinical, and occupational risk factors of recurrent stroke among the working-age group: A systematic review and meta-analysis

Araya Chiangkhong et al. Heliyon. .

Abstract

Background: Stroke recurrence is increasing in the working-age population. This study aimed to summarize and evaluate the risk factors for recurrent stroke among the working-age population.

Methods: Relevant studies were extracted from several databases following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Fixed- or random-effects estimates of the pooled odds ratio (OR) and 95% confidence interval (CI) of risk factors for recurrent stroke were generated based on heterogeneity. Subgroup and publication bias analyses were also performed.

Results: Seventeen studies were included in the meta-analysis. Pooled effects results revealed that the risk of recurrent stroke in the working-age group was as follows: Diabetes (OR = 1.85, 95% CI: 1.47, 2.32), hypertension (OR = 1.27, 95% CI: 1.12, 1.44), smoking (OR = 1.52, 95% CI: 1.27, 1.81), history of cardiac disease (OR = 2.86, 95% CI: 2.22, 3.67), history of stroke (OR = 2.45, 95% CI: 1.81, 3.31), and National Institutes of Health stroke severity score (OR = 1.09, 95% CI: 1.03, 1.15).

Conclusion: These findings suggest that several factors, such as diabetes, hypertension, smoking, history of cardiac disease and stroke, and severity of a stroke, are potential risk factors for recurrent stroke in the working-age group. Therefore, strategies to reduce those risk factors should be adopted and attention paid to prevent recurrent stroke among working-age populations.

Keywords: Meta-analysis; Recurrent stroke; Risk factors; Working-age group.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram.
Fig. 2
Fig. 2
The pooled estimates of diabetes (A), hypertension (B), alcohol (C), smoking (D), and hyperlipidemia (E) on recurrent stroke.
Fig. 3
Fig. 3
The pooled estimates of atrial fibrillation (A), history of cardiac disease (B), history of stroke (C), and NIHSS stroke severity (D) on recurrent stroke.
Fig. 4
Fig. 4
The pooled estimates of self-employed (A), skilled manual (B), nonskilled manual (C), low-level nonmanual (D), and medium-level nonmanual (E) on recurrent stroke.
Fig. 5
Fig. 5
A subgroup analysis of diabetes on recurrent stroke based on study location, comparing Western populations and Eastern populations.
Fig. 6
Fig. 6
A subgroup analysis of diabetes on recurrent stroke based on stroke type, comparing ischemic stroke and any stroke type.
See this image and copyright information in PMC

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