A method for predicting the development of stroke in men working under the influence of local vibration

Abstract

Introduction. The problem of studying the development of stroke in men of working age working in conditions of high occupational risk remains relevant. The study aims to develop a method for predicting the development of stroke in men working under the influence of local vibration. Materials and methods. The survey included 136 men aged 30 to 65 years who have worked for 5 or more years in professions: mechanical assembly fitter, installer, grinder, miller, riveter, sharpener, moulder (class of working conditions - 3.1). We divided the study participants into two groups: the first group - 72 men with stroke, the second group - 64 men who had no history of stroke. The subjects of both groups were comparable in professional composition, age and work experience. Using the method of sequential inclusion of the studied stroke risk factors (Forward Stepwise), the researchers have identified those risk factors that have made a significant contribution to the possible development of stroke. Results. Based on multifactorial analysis, the authors have derived a logistic regression formula that determines the probability of stroke in patients working under the influence of local vibration. The formula included significant factors that significantly contribute to the development of stroke: the patient's diagnosis of "arterial hypertension of the third degre" (β-coefficient=2.7, p=0.001), the absence of taking antihypertensive drugs (β-coefficient=1.3, p=0.01). To determine the probability of stroke, we determine the value of these two parameters and substitute them into the formula for calculating the value of p(X). A value of p(X) exceeding 0.8 indicates a high risk of stroke in men working under the influence of local vibration. The sensitivity of the proposed method was 72.2%, the specificity was 75.0%. Limitations. The authors excluded from this study: female sex, age less than 30 and more than 65 years, diagnosis of "transient cerebrovascular accident", work experience of less than 5 years, the presence of acute infectious diseases. Conclusion. The authors have revealed the prognostic value of a combination of individual risk factors for stroke in people working under the influence of local vibration (the presence of a diagnosis of "arterial hypertension of the third degree" in the patient, the absence of taking antihypertensive drugs). The multifactorial model is informative for the individual prediction of stroke in men when exposed to industrial local vibration. Ethics. The researchers conducted the study in compliance with the "Ethical Principles of Conducting Scientific medical research with human participation" and "Rules of Clinical Practice in the Russian Federation", approved by Order of the Ministry of Health, Russian Federation, No. 266 dated 19.06.2003; approved by the Local Ethics Committee at the Federal State Budgetary Educational Institution of the Ministry of Health, Russian Federation (minutes of the meeting No. 65 dated 27.05.2014).