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To use the multi-state model to study the risks of developing Parkinson’s disease and death after stroke and explore their influencing factors, so as to provide a scientific basis for the prognosis of stroke patients and the prevention of Parkinson’s disease.
This study was based on 345 585 participants registered in the UK Biobank database from 2006 to 2010, with follow-up until November 30, 2021. The multi-state model was used to analyze the risks of developing Parkinson’s disease and death in stroke patients.
Among the six outcome paths, the cumulative risk from stroke to death was the highest, followed by that of Parkinson’s disease and from the baseline to death. The risk probability of developing Parkinson’s disease after stroke was 2.25 times that of the baseline state, and the death probability of stroke patients was 11.36 times that of the baseline population. The results of the influencing factors in the multi-state model showed that advanced age (over 60 years old), male, depression, smoking, alcohol consumption, and childhood obesity were all risk factors for the transition of the baseline population to the three states (stroke, Parkinson’s disease, and death). In the transition path from stroke to Parkinson’s disease, advanced age (over 60 years old) was a risk factor, while alcohol consumption and female gender were protective factors for stroke patients to develop Parkinson’s disease (HR=0.569, 95%CI: 0.357-0.909), (HR=0.521, 95%CI: 0.344-0.788). In the path from stroke to death, advanced age (over 50 years old), depression (HR=1.980, 95%CI: 1.656-2.369), smoking (HR=1.504,95%CI: 1.358-1.647), and a family history of stroke could increase the risk of stroke to death, while alcohol consumption was a protective factor (HR=0.872, 95%CI: 0.774-0.984). Advanced age (over 60 years old), depression (HR=1.783, 95%CI: 1.295-2.451), and smoking (HR=1.781, 95%CI: 1.397-2.295) were risk factors for the death of Parkinson’s patients, and the mortality rate of female patients was lower than that of male patients (HR=0.797, 95%CI: 0.686-0.926).
Advanced age (over 60 years old), male gender, smoking, depression, and childhood obesity are risk factors for stroke, Parkinson’s disease, and death in the baseline population; advanced age, male, smoking, depression, and a family history of stroke are risk factors for stroke patients to develop Parkinson’s disease and die. The multi-state model can be used to demonstrate the influencing factors and extent of disease transitions, revealing the patterns of disease progression.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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