Lifestyle Factors and Early Clinical Outcome in Patients With Acute Stroke

Abstract

Background and Purpose— We examined the associations of individual and combined lifestyle factors with early adverse stroke outcomes. Methods— A total of 82 597 patients were identified from nationwide registries. Lifestyle factors at the time of stroke admission included body mass index (kg/m 2 ), smoking habits, and alcohol intake, which were grouped (healthy, moderately healthy, moderately unhealthy, and unhealthy). The associations between lifestyle and outcomes were examined using multivariable regression. Results— A total of 18.3% had a severe stroke, 7.8% pneumonia, 12.5% urinary tract infection, and 9.9% died within 30 days. The association between lifestyle, stroke severity, and mortality, respectively, differed according to sex. Unhealthy lifestyle was associated with lower risk of severe stroke (adjusted odds ratio [OR], 0.73; 95% confidence interval [CI], 0.63–0.84) and 30-day mortality among men (adjusted OR, 0.71; 95% CI, 0.58–0.87), but not among women (severe stroke: adjusted OR, 1.14; 95% CI, 0.85–1.55, and mortality: adjusted OR, 1.34; 95% CI, 0.90–1.99). No sex differences were found for pneumonia and urinary tract infection. Unhealthy lifestyle was not associated with a statistically significant increased risk of developing in-hospital pneumonia (adjusted OR, 1.30; 95% CI, 0.98–1.73) or urinary tract infection (adjusted OR, 0.98; 95% CI, 0.72–1.33). Underweight was associated with a higher 30-day mortality (men: adjusted OR, 1.71; 95% CI, 1.50–1.96, and women: adjusted OR, 1.46; 95% CI, 1.34–1.60). Conclusions— Healthy lifestyle was not associated with a lower risk of adverse stroke outcomes, in particularly among men. However, underweight may be a particular concern being associated with an increased risk of adverse outcomes among both sexes.