Lipson David M, Sangha Harpreet, Foley Norine C, Bhogal Sanjit, Pohani Gina, Teasell Robert W
Department of Physical Medicine, St Joseph's Health Care London, University of Western Ontario, London, Ontario, Canada.
Int J Rehabil Res. 2005 Dec;28(4):303-8. doi: 10.1097/00004356-200512000-00002.
The objective of this study was to compare the differences in patterns of recovery and incidence of medical complications in hemorrhagic and ischemic stroke patients admitted for rehabilitation, using a retrospective case series design. It was set in three tertiary care facilities in London, Ontario, Canada. Eight-hundred-and-nineteen consecutive patients, admitted from 1997 to 2001 for rehabilitation following cerebrovascular event, were reviewed. The main outcome measures were: age, length of hospital stay, time to admission, medical complications, ambulation status and functional independence measure scores on both admission and discharge. The results showed that 110 patients had strokes that were hemorrhagic, while 709 were ischemic. The hemorrhagic stroke patients were younger (66 vs. 70 years, P=0.001) and were admitted later post stroke onset (30 vs. 18 days, P<0.0001). They had a higher incidence of pneumonia (6.4 vs. 2.7%, P=0.04), pulmonary emboli (3.6 vs. 0.07%, P=0.006) and wheelchair ambulation on admission (53 vs. 41%, P=0.026). There was no significant difference in incidence of seizures or wheelchair ambulation on discharge, length of rehabilitation stay or Functional Independence Measure scores on both admission and discharge. In conclusion, hemorrhagic stroke patients took longer than ischemic stroke patients to enter into rehabilitation, and were more inclined to experience ambulatory impairments and develop medical complications.
本研究的目的是采用回顾性病例系列设计，比较因康复入院的出血性和缺血性中风患者的恢复模式差异及医疗并发症发生率。研究在加拿大安大略省伦敦市的三家三级护理机构进行。回顾了1997年至2001年因脑血管事件后入院康复的819例连续患者。主要结局指标包括：年龄、住院时间、入院时间、医疗并发症、行走状态以及入院和出院时的功能独立性测量得分。结果显示，110例患者为出血性中风，709例为缺血性中风。出血性中风患者更年轻（66岁对70岁，P = 0.001），中风发作后入院时间更晚（30天对18天，P < 0.0001）。他们肺炎发生率更高（6.4%对2.7%，P = 0.04）、肺栓塞发生率更高（3.6%对0.07%，P = 0.006），入院时轮椅行走比例更高（53%对41%，P = 0.026）。癫痫发作发生率、出院时轮椅行走比例、康复住院时间或入院和出院时的功能独立性测量得分无显著差异。总之，出血性中风患者比缺血性中风患者进入康复的时间更长，更易出现行走障碍并发生医疗并发症。
