Nazlı Gamze BÜLBÜL, Bilge Piri ÇINAR, Refik KUNT, Burcu YÜKSEL, Halil GÜLLÜOĞLU, İdris SAYLIR, Sibel Çeliker USLU, Eylem Özaydın GÖKSU, Baykal YILDIZ, Didem ÖZ, Ahmet Onur KESKİN, Osman KORUCU, Çetin Kürşad AKPINAR, Volkan SOLMAZ, Meliha TÜRKSEVER, Fatma Zehra ALTUNÇ, Zeynep ELMAS, Mustafa EKİCİ, Murat Mert ATMACA, Sibel KARŞIDAĞ, Mehmet Fatih ÖZDAĞ
Turkish Journal of Neurology - 2026;32(2):155-164
Objectives: This multicenter study aimed to identify the clinical, laboratory, and demographic determinants associated with stroke recurrence in a large nationwide cohort of patients presenting with acute stroke. Patients and methods: This retrospective multicenter cohort study included 1,132 patients (614 males, 518 females; mean age: 70.0 +/- 12.6 years) who hospitalized with acute stroke across tertiary centers in Türkiye between February 2016 and December 2024. Sociodemographic characteristics, vascular risk factors, clinical presentation, laboratory parameters, neuroimaging findings, and clinical outcomes were obtained from hospital records. Stroke recurrence was defined as the primary endpoint. Bivariate analyses were initially performed to evaluate associations between potential predictors and recurrence, followed by multivariate logistic regression analysis to determine independent determinants. Results: Stroke recurrence occurred in 24.3% of the cohort. In bivariate analyses, recurrence was significantly associated with hypertension (odds ratio [OR] = 1.677, p = 0.002), hyperlipidemia (OR = 1.575, p = 0.01), diabetes mellitus (OR = 1.390, p = 0.025), atrial fibrillation (OR = 2.531, p < 0.001), and carotid artery stenosis (OR = 3.085, p < 0.001). However, in multivariate logistic regression analysis, only advanced age (OR = 1.030, p < 0.001) and carotid artery stenosis (OR = 3.085, p < 0.001) remained independent predictors of stroke recurrence. Conclusion: Advanced age and carotid artery stenosis emerged as the strongest independent determinants of stroke recurrence in this nationwide multicenter cohort. These findings highlight the importance of early vascular evaluation and individualized risk stratification to improve secondary stroke prevention strategies.
