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弗雷明汉心血管风险评分在住院脑卒中患者中的预后价值。

Prognostic value of Framingham Cardiovascular Risk Score in hospitalized stroke patients.

机构信息

University of California Los Angeles Stroke Center and Department of Neurology, 710 Westwood Plaza, Los Angeles, CA 90095, USA.

出版信息

J Stroke Cerebrovasc Dis. 2011 May-Jun;20(3):222-6. doi: 10.1016/j.jstrokecerebrovasdis.2009.12.003. Epub 2010 Jul 24.

Abstract

The Framingham Coronary Risk Score (FCRS) is based on several factors, including age, sex, total cholesterol, high-density lipoprotein cholesterol, systolic blood pressure, presence of diabetes, and cigarette smoking. Some of these factors are individually linked with acute stroke outcomes. We explored whether FCRS could predict outcome in patients hospitalized with recent stroke. We collected data on consecutive patients hospitalized for ischemic stroke over a 3-year period. Patients with known coronary artery disease were excluded. Discharge outcomes assessed were neurologic deficit (National Institutes of Health Stroke Scale [NIHSS] score), death or disability (modified Rankin Scale [mRS] score ≥2), and discharge to home directly from the hospital. The independent effect of FCRS on these outcomes was evaluated using multivariate regression analysis. During the study period, 434 patients with ischemic stroke met entry criteria (mean age, 64.5 years; 54% females). Median FCRS score was 8%. After adjusting for confounders, higher FCRS score was associated with an increased likelihood of death or being disabled at discharge (odds ratio [OR]=4.9; 95% confidence interval [CI]=0.98-24.1; P=.05), and a decreased likelihood of being discharged directly to home (OR=0.18; 95% CI=0.04-0.86; P=.032), but not with discharge NIHSS score. Higher FCRS in hospitalized ischemic stroke patients is associated with death or disability at discharge and a lower likelihood of being discharged directly to home. Along with indexing the long-term risk of cardiovascular events, this widely known, easily calculable score provides clinically relevant short-term prognostic information following ischemic stroke.

摘要

弗雷明汉心脏研究风险评分(Framingham Coronary Risk Score,FCRS)基于多个因素,包括年龄、性别、总胆固醇、高密度脂蛋白胆固醇、收缩压、糖尿病和吸烟。其中一些因素与急性中风结局单独相关。我们探讨了 FCRS 是否可以预测近期中风住院患者的结局。我们收集了 3 年内因缺血性中风连续住院患者的数据。排除了已知冠状动脉疾病的患者。评估的出院结局包括神经功能缺损(国立卫生研究院中风量表 [National Institutes of Health Stroke Scale,NIHSS] 评分)、死亡或残疾(改良 Rankin 量表 [modified Rankin Scale,mRS] 评分≥2)和直接从医院出院回家。使用多变量回归分析评估 FCRS 对这些结局的独立影响。在研究期间,434 名缺血性中风患者符合入选标准(平均年龄 64.5 岁;54%为女性)。中位数 FCRS 评分为 8%。在调整混杂因素后,较高的 FCRS 评分与出院时死亡或残疾的可能性增加相关(比值比 [odds ratio,OR]=4.9;95%置信区间 [confidence interval,CI]=0.98-24.1;P=.05),以及直接出院回家的可能性降低(OR=0.18;95%CI=0.04-0.86;P=.032),但与出院 NIHSS 评分无关。住院缺血性中风患者的 FCRS 较高与出院时死亡或残疾相关,且直接出院回家的可能性较低。除了评估长期心血管事件风险外,这个广泛应用、易于计算的评分还提供了缺血性中风后具有临床意义的短期预后信息。

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