Choo W S, Foo S, Tan E, Thayaparan F S T, Chung Y Y, Raman S, Shaariah W, Chin S P
Department of Medicine, Hospital Tuanku Ja'afar, Seremban.
Med J Malaysia. 2009 Mar;64(1):34-6.
This is a prospective study to determine the severity of disability and prognosis of acute stroke patients related to their Body Mass index (BMI). A total of 79 consecutive CT-scan-proven acute stroke patients who were admitted to Hospital Tuanku Ja'afar, Seremban between November 2006 and April 2007 were recruited (male:female 49:30; mean age 62.7 years; ischemic stroke 70, intracerebral bleed 9). The patients were divided according to BMI less than 25 (Group A) and equal or greater than 25 (Group B). Severity of disability was measured between 24-48 hours by modified Rankin's score. Patients were followed up after one month. Thirty-seven patients had severe disability (Rankin Score 5). Twenty-nine patients had adverse outcomes including 11 deaths and 18 rehospitalizations or prolonged hospital/nursing home stay. 34.3% of Group B had severe disability compared to 56.8% of Group A (chi2 P = 0.046). Conversely 42.9% of Group B had adverse events at one month compared to 31.8% of Group A (chi2 P = 0.312). There were no statistical differences between high- and low-BMI groups for gender ratio, smoking, hypertension, diabetes, prior cardiovascular disease, mean age, mean lipid profile and blood pressure. When comparing patients with Rankin Score 1-4 versus 5, age and BMI were statistically significant between the two groups. By multivariate analysis only age is independent predictor for severe disability (P < 0.05). The results of this pilot study should be confirmed in larger prospective multicentre trial.
这是一项前瞻性研究，旨在确定急性中风患者的残疾严重程度及其与体重指数（BMI）的预后关系。2006年11月至2007年4月期间，共有79例经CT扫描证实的急性中风患者被收治到芙蓉端姑查法医院（男性：女性为49:30；平均年龄62.7岁；缺血性中风70例，脑出血9例）。患者根据BMI是否小于25分为两组（A组）和BMI等于或大于25的组（B组）。在24至48小时内通过改良Rankin评分来衡量残疾严重程度。患者在一个月后进行随访。37例患者有严重残疾（Rankin评分5分）。2十九例患者有不良结局，包括11例死亡和18例再次住院或延长住院/疗养院停留时间。B组34.3%的患者有严重残疾，而A组为56.8%（卡方检验P = 0.046）。相反，B组42.9%的患者在一个月时有不良事件，而A组为31.8%（卡方检验P = 0.312）。高BMI组和低BMI组在性别比例、吸烟、高血压、糖尿病、既往心血管疾病、平均年龄、平均血脂水平和血压方面无统计学差异。比较Rankin评分1 - 4分与5分的患者时，两组之间的年龄和BMI具有统计学意义。通过多变量分析，只有年龄是严重残疾的独立预测因素（P < 0.05）。这项初步研究的结果应在更大规模的前瞻性多中心试验中得到证实。
