Bohannon Richard W, Lee Nora
Institute of Outcomes Research and Evaluation, Hartford Hospital, Hartford, School of Allied Health, University of Connecticut, Storrs, CT, USA.
Conn Med. 2003 Oct;67(9):535-9.
The goal of this study of 326 patients surviving index hospitalization for stroke was to: 1) document deaths and readmissions and 2) describe the association of selected variables with these outcomes.
Stroke severity data were retrieved from our Stroke Center's database; demographics and information relevant to index and subsequent readmissions was garnered from the Hospital's administrative database. The Social Security Death Index was also used to investigate deaths.
During the year following index admission for stroke, 32.5% were readmitted at least once, 15.6% died, and 39.6% were either readmitted or died. The diagnosis-related group associated most often with the first readmission was number 14 (specific cerebrovascular disorders except transient ischemic attach). Only index length of stay had a significant bivariate correlation (r = .138) with readmission. Age, National Institutes of Health Stroke Scale (NIHSS) score, index length of stay, and index discharge destination had significant bivariate correlations (r = .129-.231) with death and death or readmission. Regression analysis showed that a combination of the NIHSS score and index length of stay provided the strongest association with death (R2 = .094) and death or readmission (R2 = .099).
Readmission and death are common during the first year after stroke. The initiation of secondary prevention strategies would appear to be highly warranted on the basis of these findings.
本研究旨在对326例卒中首次住院存活患者进行调查，以：1）记录死亡和再入院情况；2）描述选定变量与这些结局之间的关联。
从我们卒中中心的数据库中检索卒中严重程度数据；从医院行政数据库中收集人口统计学信息以及与首次和随后再入院相关的信息。还使用社会保障死亡指数调查死亡情况。
在卒中首次入院后的一年中，32.5%的患者至少再入院一次，15.6%的患者死亡，39.6%的患者再入院或死亡。与首次再入院最常相关的诊断相关组是第14组（除短暂性脑缺血发作外的特定脑血管疾病）。只有首次住院时长与再入院有显著的双变量相关性（r = 0.138）。年龄、美国国立卫生研究院卒中量表（NIHSS）评分、首次住院时长和首次出院去向与死亡以及死亡或再入院有显著的双变量相关性（r = 0.129 - 0.231）。回归分析表明，NIHSS评分和首次住院时长的组合与死亡（R2 = 0.094）以及死亡或再入院（R2 = 0.099）的关联最强。
卒中后的第一年，再入院和死亡很常见。基于这些发现，二级预防策略的启动似乎非常必要。
