Mizrahi Eliyahu H, Fleissig Yehudit, Arad Marina, Kaplan Alexander, Adunsky Abraham
Department of Geriatric Rehabilitation, Sheba Medical Center, Tel Hashomer 52621, Israel.
Disabil Rehabil. 2007 Jul 30;29(14):1091-5. doi: 10.1080/09638280600929177.
Diabetes is associated with more ischemic strokes and diabetic patients have up to a three-fold increased risk for suffering a stroke, compared with non-diabetics. The aim of this study is to evaluate whether diabetes mellitus may also affect the functional outcome of patients with acute ischemic stroke, undergoing post-acute care rehabilitation.
A retrospective charts analysis of consecutive older patients with acute ischemic stroke admitted for rehabilitation at a tertiary hospital with post-acute care geriatric rehabilitation wards. Functional outcome of diabetics and non-diabetics was assessed by the Functional Independence Measurement scale (FIM) at admission and discharge. Data were analysed by t-tests, Pearson correlation, and Chi-square test, as well as by linear regression analysis.
A total number of 527 patients were admitted, of whom 39% were diabetics. Compared with non-diabetics, diabetic stroke patients were slightly younger (p = 0.0001) but had similar admission FIM scores. FIM gain parameters (total FIM gain, motor FIM gain, daily total and motor FIM gains) upon discharge were similar in both groups. A linear regression analysis showed that higher MMSE scores (beta = 0.08; p = 0.01) and higher admission total FIM scores (beta = 0.87; p < 0.001) predicted higher total FIM scores upon discharge. Diabetes mellitus was not interrelated, whatsoever, with better total FIM scores upon discharge (beta = -0.03; p = 0.27).
The findings suggest that there is no difference in the functional outcome of diabetic and non-diabetic patients, presenting for rehabilitation after acute ischemic stroke. Diabetes should not be considered as adversely affecting rehabilitation of such patients.
糖尿病与更多的缺血性卒中相关，与非糖尿病患者相比，糖尿病患者发生卒中的风险增加了两倍。本研究旨在评估糖尿病是否也会影响接受急性缺血性卒中后康复治疗患者的功能结局。
对一家设有急性后期老年康复病房的三级医院中因康复治疗而收治的连续性急性缺血性卒中老年患者进行回顾性病历分析。通过功能独立性测量量表（FIM）在入院时和出院时评估糖尿病患者和非糖尿病患者的功能结局。采用t检验、Pearson相关性分析、卡方检验以及线性回归分析对数据进行分析。
共收治527例患者，其中39%为糖尿病患者。与非糖尿病患者相比，糖尿病卒中患者年龄稍小（p = 0.0001），但入院时FIM评分相似。两组出院时的FIM改善参数（FIM总分改善、运动FIM改善、每日FIM总分及运动FIM改善）相似。线性回归分析显示，较高的简易精神状态检查表（MMSE）评分（β = 0.08；p = 0.01）和较高的入院FIM总分（β = 0.87；p < 0.001）预示着出院时FIM总分较高。糖尿病与出院时较好的FIM总分并无关联（β = -0.03；p = 0.27）。
研究结果表明，急性缺血性卒中后接受康复治疗的糖尿病患者和非糖尿病患者在功能结局方面没有差异。糖尿病不应被视为对这类患者的康复有不利影响。
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