Seo WhaSook, Oh HyunSoo
Department of Nursing, College of Medicine, Inha University, Incheon, Republic of Korea.
J Stroke Cerebrovasc Dis. 2007 Mar-Apr;16(2):57-63. doi: 10.1016/j.jstrokecerebrovasdis.2006.10.005.
This study was conducted to evaluate the prognostic values of acute physiologic parameters of mortality and functional and cognitive recovery. We studied 108 patients with hemorrhagic stroke admitted within 24 hours after stroke onset to a neurologic intensive care department. Details concerning potential physiologic predictors were collected (i.e., systolic and diastolic blood pressure, pulse rate, respiration rate, body temperature, hematocrit, Pao(2), Paco(2) and serum osmolality, pH, cholesterol, and glucose levels) at admission. As outcome variables, mortality and functional and cognitive recovery at 1, 3, and 6 months were measured. Results showed that blood pressure, serum pH, and Pao(2) on admission are significant predictors of mortality; that respiratory rate and hematocrit on admission are significant predictors of functional recovery; and that respiratory rate, Pao(2), and heart rate on admission predict cognitive recovery. It appears that the physiologic predictors of hemorrhagic stroke are remarkably dependent on outcome definitions (i.e., mortality, functional disability, or cognitive ability), but not with recovery times.
本研究旨在评估急性生理参数对死亡率以及功能和认知恢复的预后价值。我们研究了108例在卒中发作后24小时内入住神经重症监护病房的出血性卒中患者。入院时收集了有关潜在生理预测指标的详细信息(即收缩压和舒张压、脉搏率、呼吸频率、体温、血细胞比容、动脉血氧分压、动脉血二氧化碳分压、血清渗透压、pH值、胆固醇和血糖水平)。作为结局变量,测量了1、3和6个月时的死亡率以及功能和认知恢复情况。结果显示,入院时的血压、血清pH值和动脉血氧分压是死亡率的重要预测指标;入院时的呼吸频率和血细胞比容是功能恢复的重要预测指标;入院时的呼吸频率、动脉血氧分压和心率可预测认知恢复。出血性卒中的生理预测指标似乎显著依赖于结局定义(即死亡率、功能残疾或认知能力),但与恢复时间无关。