Division of Health and Social Care Research, King's College London, London, UK.
Int J Stroke. 2011 Apr;6(2):112-7. doi: 10.1111/j.1747-4949.2010.00558.x. Epub 2010 Dec 16.
Little is known about the poststroke outcome in Caribbean populations. We investigated differences in the activities of daily living, level of social activities, living circumstances and survival for stroke patients in Barbados and London.
Data were collected from the South London Stroke Register and the Barbados Register of Strokes for patients with a first-ever stroke registered between January 2001 and December 2004. The ability to perform activities of daily living was measured by the Barthel Index and level of social activities by the Frenchay Activities Index. Living circumstances were categorised into private household vs. institutional care. Death and dependency, activities of daily living and social activities were assessed at three-months, one- and two-years using logistic regression, adjusted for differences in demographic, socioeconomic and stroke severity characteristics.
At three-months, a high level of social activities was more likely for the Barbados Register of Strokes (odds ratio 1.84; 95% confidence interval 1.03-3.29); there were no differences in activities of daily living; and Barbados Register of Strokes patients were less likely to be in institutional care (relative risk ratio 0.38; 95% confidence interval 0.18-0.79). Following adjustment, Barbados Register of Strokes patients had a higher risk of mortality at three-months (relative risk ratio 1.85; 95% confidence interval 1.03-3.30), one-year (relative risk ratio 1.83; 95% confidence interval 1.08-3.09) and two-years (relative risk ratio 1.82; 95% confidence interval 1.08-3.07). This difference was due to early poststroke deaths; for patients alive at four-weeks poststroke, survival thereafter was similar in both settings.
In Barbados, there was evidence for a healthy survivor effect, and short-term social activity was greater than that in the South London Stroke Register.
关于加勒比地区人群中风后的结果，人们知之甚少。我们调查了巴巴多斯和伦敦的中风患者在日常生活活动能力、社会活动水平、生活环境和生存率方面的差异。
数据来自 2001 年 1 月至 2004 年 12 月期间登记的首次中风的南伦敦中风登记处和巴巴多斯中风登记处。日常生活活动能力通过巴氏指数（Barthel Index）进行测量，社会活动水平通过 Frenchay 活动指数（Frenchay Activities Index）进行测量。生活环境分为私人家庭和机构护理。使用逻辑回归，在调整人口统计学、社会经济和中风严重程度特征的差异后，在三个月、一年和两年时评估死亡和依赖、日常生活活动和社会活动。
在三个月时，巴巴多斯中风登记处的患者更有可能进行高水平的社会活动（优势比 1.84；95%置信区间 1.03-3.29）；日常生活活动没有差异；而且，巴巴多斯中风登记处的患者更不可能在机构中接受护理（相对风险比 0.38；95%置信区间 0.18-0.79）。调整后，巴巴多斯中风登记处的患者在三个月（相对风险比 1.85；95%置信区间 1.03-3.30）、一年（相对风险比 1.83；95%置信区间 1.08-3.09）和两年（相对风险比 1.82；95%置信区间 1.08-3.07）时的死亡率更高。这种差异是由于中风后早期死亡所致；对于中风后四周仍存活的患者，此后的生存情况在两个环境中相似。
在巴巴多斯，有证据表明存在健康幸存者效应，而且短期社会活动水平高于南伦敦中风登记处。
