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Factors associated with newly diagnosed ischemic stroke among people in Thailand: A population-based case-control study

Phasom, J.; Ungcharoen, R.; Pusuwan, P.; Phoosuwan, N.

2025-02-02 public and global health
10.1101/2025.01.29.25321321 medRxiv
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BackgroundStroke is a leading cause of death and disability-adjusted life years globally. The incidence of stroke is increasing in Asia, with ischemic stroke accounting for approximately 80% of stroke cases in Thailand. Stroke often results in long-term disabilities, including impairments in speech, communication, and concentration. ObjectiveThis study aimed to investigate factors associated with newly diagnosed ischemic stroke. MethodsA matched case-control study was conducted, including 154 newly diagnosed ischemic stroke cases and 183 non-stroke individuals with type 2 diabetes mellitus (T2DM) as controls. Data were collected between February and September 2022 (post-COVID-19 period) using a structured questionnaire covering (1) socio-demographics, (2) lifestyle factors, (3) perceived social support, and (4) self-care management (SCM). Multivariable logistic regression models were employed to calculate adjusted odds ratios (aOR) with 95% confidence intervals (CI). ResultsMost participants were female (60.8%), Buddhists (92.9%), and agriculturists (66.5%), with a mean age of 58.9 ({+/-}9.9) years. Factors associated with ischemic stroke included male sex (aOR=3.533, 95%CI 1.732-7.206), Buddhism (aOR=3.529, 95%CI 1.107-11.250), sedentary occupation (aOR=5.785, 95%CI 2.613-12.807), and having T2DM for over 10 years (aOR=6.194, 95%CI 3.553-10.798). Protective factors included age [≥] 60 years (aOR=0.553, 95%CI 0.312-0.982) and moderate SCM levels (aOR=0.453, 95%CI 0.256-0.802). ConclusionProlonged T2DM and sedentary occupations significantly contribute to ischemic stroke incidence. Effective prevention programs, including lifestyle modifications and diabetes self-care management education, may help reduce the burden of ischemic stroke.

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