Liu M, Tsuji T, Tsujiuchi K, Chino N
Department of Rehabilitation Medicine, Saitama Prefecture General Rehabilitation Center, Japan.
Am J Phys Med Rehabil. 1999 Sep-Oct;78(5):416-24. doi: 10.1097/00002060-199909000-00004.
We previously reported reliability and validity of our newly developed comorbidity scale (CS) for stroke outcome research based on a retrospective sample. The objectives of this study were to cross-validate the comorbidity scale in a new prospective sample and to investigate longitudinal changes of the comorbidity scale during hospitalization. In a prospective sample of 175 stroke patients admitted to five nonacute rehabilitation hospitals in Japan, we analyzed the frequency and grading of comorbidities and compared the comorbidity scale with demographic data, impairment as assessed with the Stroke Impairment Assessment Set (SIAS), and disability as measured with the Functional Independence Measure (FIM(SM)). The results were compared with our previous retrospective study. We also studied longitudinal changes by measuring the comorbidity scale on admission, 2 wk later, and at discharge of 67 patients. As a result, the comorbidity scaling was significantly lower in the prospective sample, and it increased at the second measurement and then plateaued. Among the comorbidities, hypertension ranked first, followed by shoulder pain, and diabetes mellitus. Similar to our previous retrospective study, the comorbidity scale correlated positively with age and length of stay and correlated negatively with the SIAS motor item scores and the FIM scores. In conclusion, the present study suggested concurrent and predictive validity of the comorbidity scale in a prospective sample as well and clarified the comorbidity characteristics of stroke inpatients.
我们之前基于回顾性样本报告了新开发的合并症量表（CS）用于卒中结局研究的信度和效度。本研究的目的是在新的前瞻性样本中对合并症量表进行交叉验证，并调查住院期间合并症量表的纵向变化。在日本五家非急性康复医院收治的175例卒中患者的前瞻性样本中，我们分析了合并症的频率和分级，并将合并症量表与人口统计学数据、用卒中损伤评定量表（SIAS）评估的损伤以及用功能独立性测量（FIM(SM)）测量的残疾进行了比较。将结果与我们之前的回顾性研究进行了比较。我们还通过测量67例患者入院时、2周后和出院时的合并症量表来研究纵向变化。结果显示，前瞻性样本中的合并症评分显著较低，在第二次测量时升高，然后趋于平稳。在合并症中，高血压位居首位，其次是肩部疼痛和糖尿病。与我们之前的回顾性研究相似，合并症量表与年龄和住院时间呈正相关，与SIAS运动项目评分和FIM评分呈负相关。总之，本研究表明合并症量表在前瞻性样本中也具有同时效度和预测效度，并阐明了卒中住院患者的合并症特征。
