Mizrahi Eliyahu Hayim, Waitzman Anna, Arad Marina, Adunsky Abraham
Department of Geriatric Medicine and Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel.
Isr Med Assoc J. 2011 May;13(5):295-9.
Total cholesterol is significantly associated with increased risk of ischemic stroke. Patients with ischemic stroke and high cholesterol levels may show better functional outcome after rehabilitation.
To study the possible interrelations between hypercholesterolemia and functional outcome in elderly survivors of ischemic stroke.
We conducted a retrospective chart review study of consecutive patients (age > or = 60 years) with acute stroke admitted to a geriatric rehabilitation ward in a university-affiliated hospital. The presence or absence of hypercholesterolemia was based on registry data positive for hypercholesterolemia, defined as total cholesterol > or = 200 mg/dl (5.17 mmol/L). Functional outcome of patients with hypercholesterolemia (Hchol) and without (NHchol) was assessed by the Functional Independence Measurement scale (FIM) at admission and discharge. Data were analyzed by t-test and chi-square test, as well as linear regression analysis.
The complete data for 551 patients (age range 60-96 years) were available for final analysis; 26.7% were diagnosed as having hypercholesterolemia. Admission total FIM scores were significantly higher in patients with Hchol (72.1 +/- 24.8) compared with NHchol patients (62.2 +/- 24.7) (P < 0.001). A similar difference was found at discharge (Hchol 90.8 +/- 27.9 vs. NHchol 79.7 +/- 29.2, P < 0.001). However, total FIM change upon discharge was similar in both groups (18.7 +/- 13.7 vs. 17.6 +/- 13.7, P = 0.4). Regression analyses showed that high Mini Mental State Examination scores (beta = 0.13, P = 0.01) and younger age (beta = -0.12, P = 0.02) were associated with higher total FIM change scores upon discharge. Total cholesterol was not associated with better total FIM change on discharge (beta = -0.012, P = 0.82).
Elderly survivors of stroke with Hchol who were admitted for rehabilitation showed higher admission and discharge FIM scores but similar functional FIM gains as compared to NHchol patients. High cholesterol levels may be useful in identifying older individuals with a better rehabilitation potential.
总胆固醇与缺血性中风风险增加显著相关。患有缺血性中风且胆固醇水平高的患者在康复后可能有更好的功能预后。
研究缺血性中风老年幸存者中高胆固醇血症与功能预后之间可能的相互关系。
我们对一家大学附属医院老年康复病房收治的连续急性中风患者（年龄≥60岁）进行了一项回顾性病历审查研究。高胆固醇血症的有无基于登记数据中高胆固醇血症呈阳性，定义为总胆固醇≥200mg/dl（5.17mmol/L）。通过功能独立性测量量表（FIM）在入院时和出院时评估有高胆固醇血症（Hchol）和无高胆固醇血症（NHchol）患者的功能预后。数据采用t检验、卡方检验以及线性回归分析。
551例患者（年龄范围60 - 96岁）的完整数据可供最终分析；26.7%被诊断为患有高胆固醇血症。与NHchol患者（62.2±24.7）相比，Hchol患者入院时的FIM总分显著更高（72.1±24.8）（P<0.001）。出院时也发现了类似差异（Hchol为90.8±27.9，NHchol为79.7±29.2，P<0.001）。然而，两组出院时FIM总分的变化相似（18.7±13.7对17.6±13.7，P = 0.4）。回归分析表明，简易精神状态检查表得分高（β = 0.13，P = 0.01）和年龄较小（β = -0.12，P = 0.02）与出院时FIM总分变化得分较高相关。总胆固醇与出院时更好的FIM总分变化无关（β = -0.012，P = 0.82）。
因康复入院的患有Hchol的中风老年幸存者与NHchol患者相比，入院时和出院时的FIM得分更高，但功能FIM增益相似。高胆固醇水平可能有助于识别具有更好康复潜力的老年人。
