中风康复的主要结果：泰国的一项多中心研究。

Main outcomes of stroke rehabilitation: a multi-centre study in Thailand.

作者信息

Kuptniratsaikul Vilai, Kovindha Apichana, Dajpratham Piyapat, Piravej Krisna

机构信息

Rehabilitation Medicine Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

出版信息

J Rehabil Med. 2009 Jan;41(1):54-8. doi: 10.2340/16501977-0288.

DOI:10.2340/16501977-0288

PMID:19197570

Abstract

OBJECTIVE

To estimate the efficiency of inpatient rehabilitation for patients after stroke in Thailand.

DESIGN

Multi-centre, prospective study.

SUBJECTS

Patients after stroke, aged >or= 18 years, with stable medical signs, able to follow 1-step commands and to sit for at least 30 min.

METHODS

Main outcomes included Barthel Index (BI) scores, BI effectiveness, BI efficiency, length of stay, Thai Hospital Anxiety and Depression Scale (HADS) scores, and quality of life.

RESULTS

Of a total of 327 patients, 285 completed the programmes, with a mean length of stay of 27.3 days. Mean age was 62.1 (standard deviation (SD) 12.1) years and 59% of patients were male. Mean BI scores on admission and at discharge were 7.48 (SD 3.96; range 0-19) and 13.27 (SD 4.86; range 0-20), respectively. The change score was 5.79 (SD 3.89) and the efficiency of functional score was 0.28 points/day. Using multivariate analysis, factors associated with change in BI score were age, previous stroke and length of stay. Sixty-four patients (25.5%) had anxiety and 95 (37.8%) had depression on admission. At discharge, the numbers of patients with anxiety and depression decreased to 17 (6.8%) and 41 (16.3%), respectively. The quality of life scores at discharge were significantly higher than those on admission.

CONCLUSION

Inpatient rehabilitation enabled stroke patients to reach optimal functional ability, and improved psychological status and quality of life.

摘要

目的

评估泰国中风患者住院康复治疗的效果。

设计

多中心前瞻性研究。

研究对象

年龄≥18岁、医学体征稳定、能听从一步指令且能坐至少30分钟的中风患者。

方法

主要结局指标包括巴氏指数（BI）评分、BI有效性、BI效率、住院时间、泰国医院焦虑抑郁量表（HADS）评分及生活质量。

结果

总共327例患者中，285例完成了治疗项目，平均住院时间为27.3天。平均年龄为62.1（标准差（SD）12.1）岁，59%的患者为男性。入院时和出院时的平均BI评分分别为7.48（SD 3.96；范围0 - 19）和13.27（SD 4.86；范围0 - 20）。变化评分为5.79（SD 3.89），功能评分效率为0.28分/天。采用多变量分析，与BI评分变化相关的因素为年龄、既往中风史和住院时间。64例患者（25.5%）入院时存在焦虑，95例患者（37.8%）存在抑郁。出院时，焦虑和抑郁患者数量分别降至17例（6.8%）和41例（16.3%）。出院时的生活质量评分显著高于入院时。