Aphasia Institute (incorporating the Pat Arato Aphasia Centre), Toronto, ON, Canada.
Arch Phys Med Rehabil. 2010 Feb;91(2):196-202. doi: 10.1016/j.apmr.2009.09.020.
To determine the incidence rate of inpatient stroke-induced aphasia in Ontario, Canada, and to examine the demographic and clinical characteristics for stroke patients with and without aphasia.
Age- and sex-specific incidence rates for aphasia in Ontario were calculated using the Ontario Stroke Audit. In addition, data collected from the Registry of the Canadian Stroke Network (RCSN) were used to determine the demographic and clinical characteristics for stroke patients with and without aphasia.
All hospitals and regional stroke centers in Ontario, Canada.
The Ontario Stroke Audit is a representative weighted sample of more than 3000 stroke inpatients admitted to emergency departments in all hospitals in Ontario within the 2004/2005 fiscal year. RCSN data included a cohort of more than 15,000 consecutive patients presenting with stroke at 12 regional stroke centers in Ontario from 2003 to 2007.
Not applicable.
Presence of aphasic symptoms on admission to hospital and at discharge, age and sex, stroke type and severity, severity of disability, services received in hospital, length of stay, and discharge destination.
Thirty-five percent (1131/3207) of adult patients admitted with a diagnosis of stroke in the province of Ontario during the 2004 to 2005 Ontario Stroke Audit had symptoms of aphasia at the time of discharge. This amounts to an incidence rate of 60 per 100,000 persons per year. Risk of aphasia increased significantly with age. In comparison with nonaphasic stroke patients, patients with aphasia were older, presented with more severe strokes on admission, had more severe disability, and were more frequently discharged to long-term care and/or rehabilitation (unadjusted results). Adjusting for stroke severity, age, sex, comorbidity, and stroke subtype, the presence of aphasia was found to be an independent predictor of longer hospital stays, increased use of rehabilitation services, and higher rates of thrombolytic therapy.
A significant number of people with stroke experience aphasia, with advancing age associated with a higher risk. The profile and patterns for stroke patients with aphasia differed significantly from those who did not experience aphasia as a residual disability after stroke, particularly in relation to service usage. Given the personal and system cost associated with aphasia, best practices in the area of stroke should include recommendations on how to best serve this population throughout the clinical pathway.
确定加拿大安大略省住院卒中后失语症的发病率，并研究有和无失语症的卒中患者的人口统计学和临床特征。
使用安大略卒中审计（Ontario Stroke Audit）计算安大略省特定年龄和性别的失语症发病率。此外，还使用加拿大卒中网络登记处（Registry of the Canadian Stroke Network，RCSN）的数据来确定有和无失语症的卒中患者的人口统计学和临床特征。
加拿大安大略省所有医院和区域卒中中心。
安大略卒中审计是对 2004/2005 财政年度期间安大略省所有医院急诊室收治的 3000 多名卒中住院患者进行的代表性加权样本。RCSN 数据包括 2003 年至 2007 年期间安大略省 12 个区域卒中中心收治的 15000 多名连续卒中患者的队列。
无。
入院时和出院时存在失语症状、年龄和性别、卒中类型和严重程度、残疾严重程度、住院期间接受的服务、住院时间和出院去向。
在安大略省 2004 年至 2005 年期间的安大略卒中审计中，诊断为卒中的成年患者中，35%（1131/3207）在出院时存在失语症状。这相当于每年每 10 万人中有 60 例。失语症的风险随年龄显著增加。与非失语症卒中患者相比，失语症患者年龄更大，入院时卒中更严重，残疾更严重，更常被送往长期护理和/或康复机构（未经调整的结果）。在调整了卒中严重程度、年龄、性别、合并症和卒中亚型后，失语症的存在是住院时间延长、康复服务使用增加和溶栓治疗率升高的独立预测因素。
大量卒中患者经历失语症，随着年龄的增长，风险增加。有和无失语症作为卒中后残留残疾的患者的特征和模式明显不同，尤其是在服务使用方面。鉴于失语症与个人和系统成本相关，卒中领域的最佳实践应包括如何在整个临床路径中为这一人群提供最佳服务的建议。
