Proportion, Risk Factors and Outcome of Lacunar Infarction: A Hospital-Based Study in a Chinese Population

BACKGROUND: There is scant information on the proportion, risk factors and outcome of lacunar infarction in China. METHODS: Prospective registry data entered within 1 month after a first-ever stroke between March 2002 and March 2007 were used from 4 Chinese hospitals. Data regarding stroke risk factors and baseline characteristics were examined in a long-term follow-up. Case fatality, death and dependency, and stroke recurrence were assessed at 30, 90, 180 days and 1 year. Predictive factors for death at 1 year in patients with lacunar infarction were tested by logistic regression analysis. We constructed Kaplan-Meier survival curves and compared groups with lacunar infarction and nonlacunar infarction by means of log rank tests for significant difference. RESULTS: A total of 3,905 patients with first-ever cerebral infarction were included, of whom 1,650 (42.3%) had a lacunar infarction and 2,255 (57.7%) a nonlacunar infarction. Case fatality was lower in patients with lacunar infarction at all 4 time points (5.3, 6.4, 7.8 and 17.4%, respectively), as compared to patients with nonlacunar infarction (9.5, 14.3, 16.5 and 20.1%, respectively). Age, diabetes, smoking and NIHSS score at admission were the independent predictors for 1-year case fatality in patients with lacunar infarction. Death and dependency rates were also lower in patients with lacunar infarction than in those with nonlacunar infarction. Recurrent stroke was an important cause of death for lacunar infarction patients. CONCLUSIONS: The proportion of lacunar infarction in China is much higher than that in Western countries. The long-term prognosis of lacunar infarction is not benign.