Clinical and phenotypical features of stroke and forecast in workers under exposure industrial noise

Abstract

Introduction. The problem of preventing the development of stroke in workers under the influence of harmful production factors is urgent. The aim of the study was to study the characteristics of stroke in men under conditions of industrial noise exposure, to establish the prognostic value in the formation and course of the disease. Material and methods. The study involved 71 men with stroke from 30 to 65 years old, who worked in conditions of industrial noise in the professions of "pilot of civil aviation aircraft" and "adjuster of railway construction machines" for 5 years or more. In order to develop a mathematical model for predicting the development of stroke and to establish an individual risk, a group of 81 men from 30 to 65 years old, working under conditions of exposure to occupational noise for 5 years or more, who had no history of stroke data, were also examined. Using the method of sequential inclusion of the studied risk factors (Forward Stepwise), we selected those that made an independent significant contribution to the development of stroke. Based on the results obtained, a logistic regression formula was created, which determines the likelihood of stroke in men working under conditions of occupational noise. Results. In the group of patients with stroke, persons of middle age were found significantly more often - 53.5%. Ischemic stroke prevailed among clinical forms - 90.1%. Among the risk factors prevailed: arterial hypertension (AH) in 100.0% of cases, dyslipidemia factor in 78.9%, smoking factor in 59.1%. A direct moderate correlation was found between the level of systolic blood pressure, diastolic blood pressure and the index of the NIHSS 1 and NIHSS 2 scales. The influence of the following factors on the development of stroke was established: the level of total cholesterol (β-coefficient=1.0, p=0.001), the presence of atrial fibrillation factor (β-coefficient=2.9, p=0.004), the presence of a factor of alcohol abuse (β-coefficient=1.1, p=0.049), the patient has a diagnosis of grade 2 AH (β-coefficient=13, p=0.041) or a diagnosis of grade 3 hypertension (β-coefficient=1.8, p=0.008). A p(X) value exceeding 0.5 indicates a high risk of developing a stroke. The sensitivity of the proposed method was 76.1%, specificity - 74.1%. Conclusion. The proposed multivariate model is informative for the individual prediction of the development of stroke in men working in conditions of exposure to occupational noise, because reflects the degree of influence of one factor or another on the development of the disease.