Problems of Social Hygiene, Public Health and History of MedicineProblems of Social Hygiene, Public Health and History of Medicine0869-866X2412-2106Joint-Stock Company Chicot38710.32687/0869-866X-2020-28-5-916-921Научная статьяThe disorder of cerebral circulation in patients of able-bodied ageBrynzaN. S.-ProklovaT. N.-LebedevaD. I.j.lebedeva1965@mail.ruDyachkovS. M.-ElfimovaI. V.-SvistunovaA. Iu.-The Federal State Budget Educational Institution of Higher Education “The Tyumen State Medical University” of Minzdrav of RussiaN. A. Semashko National Research Institute of Public HealthThe Tyumen Cardiology Research Center the Branch of the Federal State Budget Educational Institution of Higher Education “The Tyumen State Medical University” of Minzdrav of Russia1512202028591692106042021Copyright © 2020,2020The study was organized to evaluate influence of risk factors on hospital mortality in patients with acute stroke because incidence of stroke in patients of able-bodied age is increasing. All cases of in-patient care of patients of able-bodied age with acute stroke (n=4118) in the Tyumen Oblast clinical hospital № 2 during 2010-2018 were analyzed. The study was based on sampling data from hospital medical records. During the analyzed period, decreasing of in-patient lethality up to 34.9% in patients of able-bodied age was observed. During the period of “therapeutic window” 60% of patients of able-bodied age admitted died. The multivariate analysis was applied to assess influence of different factors on in-patient mortality. The presence of coronary heart disease increases risk of mortality up to 47.5%, Exp(Beta)=1.475, employment - up to 66.8%, Exp(Beta)=1.668 as compared to baseline risk. The presence of arterial hypertension and remoteness of symptom onset in ln (hours) (hospital admission) decreases mortality risk up to approximately 39.7%, Exp (Beta)=0.603 and up to 24.0%, Exp (Beta)=0.760, respectively (specificity - 75.86%, sensitivity - 72.18%; overall diagnostic accuracy - 75.23%). In patients of working age the presence of coronary heart disease and elder age are risk factors of stroke. The presence of coronary heart disease and employment are risk factors of in-patient mortality. Whereas presence of hypertension and employment decreases risk of lethal outcome.strokehemorrhage strokeischemic strokeable-bodied ageemploymentlethalityrisk factorострое нарушение мозгового кровообращениягеморрагический инсультишемический инсульттрудоспособный возрастработалетальностьфакторы риска[Feigin V., Brainin M. Reducing the burden of stroke: Opportunities and mechanisms. Int. J. Stroke. 2019;14(8):761-2. doi: 10.1177/1747493019874718][Мачинский П. А., Плотникова Н. А., Ульянкин В. Е., Рыбаков А. Г., Макеев Д. А. Сравнительная характеристика показателей заболеваемости ишемическим и геморрагическим инсультом в России. Известия высших учебных заведений. Поволжский регион. Медицинские науки. 2019;2(50):112-32. doi: 10.21685/2072-3032-2019-2-11][Лебедева Д. И., Брынза Н. С., Нямцу А. М., Акарачкова Е. С., Орлова А. С. Особенности факторов риска и эпидемиологические характеристики инсульта у женщин в Тюменской области. Профилактическая медицина. 2018;21(2-1):48-54. doi: 10.17116/profmed201821248-54][Leng T., Xiong Z. G. Treatment for ischemic stroke: From thrombolysis to thrombectomy and remaining challenges. Brain Circ. 2019;5(1):8-11. doi: 10.4103/bc.bc_36_18][Кенжеева К. О. Инсульт у молодых пациентов. Мировая наука. 2018;11(20):374-6.][Орлова А. С., Меньшова Н. И., Румянцева С. А., Силина Е. В., Ступин В. А., Орлов В. А. Сердечно-сосудистая коморбидность и дисбаланс свободнорадикальных процессов у больных с острым нарушением мозгового кровообращения. Казанский медицинский журнал. 2013;94(6):813-7.][Marshall I. J., Wang Y., Crichton S., McKevitt C., Rudd A. G., Wolfe C. D. The effects of socioeconomic status on stroke risk and outcomes. Lancet Neurol. 2015;14:1206-18. doi: 10.1016/S1474-4422(15)00200-8][Booth J., Connelly L., Lawrence M., Chalmers C., Joice S., Becker C. Evidence of perceived psychosocial stress as a risk factor for stroke in adults: a meta-analysis. BMC Neurol. 2015;15:233. doi: 10.1186/s12883-015-0456-4][Kivimäki M., Kawachi I. Work Stress as a risk factor for cardiovascular disease. Curr. Cardiol. Rep. 2015;17:630. doi: 10.1007/s11886-015-0630-8][Theorell T., Jood K., Järvholm L. S., Vingård E., Perk J., Östergren P. O. A systematic review of studies in the contributions of the work environment to ischemic heart disease development. Eur. J. Public. Health. 2016;26:470-7. doi: 10.1093/eurpub/ckw025][Евтушенко С. К., Филимонов Д. А., Евтушенко И. С. Новые факторы риска развития инсульта у лиц молодого возраста. Журнал неврологии и психиатрии им. С. С. Корсакова. Спецвыпуски. 2015;115(12):3-12. doi: 10.17116/jnevro20151151223-12][Lloyd-Jones D., Adams R., Carnethon M., De Simone G., Ferguson T. B., Flegal K. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics - 2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009;119(3):480-6. doi: 10.1161/CIRCULATIONAHA.108.191259][Sposato L. A., Brown D. L. Sex differences in the use of therapeutic resources and stroke outcomes in 5 randomized trials. Neurology. 2019;93(24):1025-7. doi: 10.1212/WNL.0000000000008610][Mirzaei H. Stroke in women: risk factors and clinical biomarkers. J. Cell. Biochem. 2017;118(12):4191-202. doi: 10.1002/jcb.26130][Fransson E. I., Nyberg S. T., Heikkilä K., Alfredsson L., Bjorner J. B., Borritz M. Job strain and the risk of stroke: an individualparticipant data meta-analysis. Stroke. 2015;46:557-9. doi: 10.1161/STROKEAHA.114.008019][Kivimäki M., Jokela M., Nyberg S. T., Singh-Manoux A., Fransson E. I., Alfredsson L. Long working hours and risk of coronary heart disease and stroke: a systematic review and meta-analysis of published and unpublished data for 603,838 individuals. Lancet. 2015;386:1739-46. doi: 10.1016/S0140-6736(15)60295-1][Kecklund G., Axelsson J. Health consequences of shift work and insufficient sleep. BMJ. 2016;355:i5210. doi: 10.1136/bmj.i5210][Ke D. S. Overwork, stroke, and karoshi-death from overwork. Acta Neurol. Taiwan. 2012;21:54-9.][Siegrist J. Effort-reward imbalance at work and cardiovascular diseases. Int. J. Occup. Med. Environ. Health. 2010;23:279-85. doi: 10.2478/v10001-010-0013-8][Birkeland Nielsen M., Einarsen S. Outcomes of exposure to workplace bullying: A meta-analytic review. Work Stress. 2015;26:309-32. doi: 10.1080/02678373.2012.734709][Rodriguez-Munoz A., Moreno-Jiménez B., Sanz-Verkgel A. I. Reciprocal relations between workplace bullying, anxiety, and vigor: a two-wave longitudinal study. Anx. Stress Coping. 2015;28:514-30. doi: 10.1080/10615806.2015.1016003]