Kashihara Michiharu, Nakao Shigetaka, Kawasaki Jun, Takata Shinjiro, Nagahiro Shinji, Kaji Ryuji, Yasui Natsuo
Department of Orthopedics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan.
J Med Invest. 2011 Aug;58(3-4):227-34. doi: 10.2152/jmi.58.227.
The objective of this study was to examine the possibility of predicting the long-term outcome of severe stroke patients from the ADL status at discharge. The design is a retrospective observational study in the stroke center at Tokushima University Hospital. Severe stroke patients at discharge with Barthel Index (BI) scores ≤ 40 (N=51) were divided into two subgroups retrospectively, improved and unimproved. The Functional Independence Measure (FIM) and BI were analyzed at discharge, 3 and 6 months after onset. Correlation analysis between BI and FIM showed good correlation, especially between BI and motor FIM (mFIM). In conclusion, the ADL status at discharge from a stroke center is not definitely indicative of the long-term outcome, although good recovery of severe stroke cases was observed in males and younger patients, and in patients with motor FIM score>25. This result shows that the first 3 months after the attack should be regarded as an important time window for intensive rehabilitation.
本研究的目的是探讨根据出院时的日常生活活动（ADL）状态预测重症中风患者长期预后的可能性。本研究为德岛大学医院中风中心的一项回顾性观察研究。将出院时Barthel指数（BI）评分≤40的重症中风患者（N = 51）回顾性地分为改善组和未改善组两个亚组。在发病后出院时、3个月和6个月对功能独立性测量（FIM）和BI进行分析。BI与FIM之间的相关性分析显示出良好的相关性，尤其是BI与运动FIM（mFIM）之间。总之，中风中心出院时的ADL状态并不能明确预示长期预后，尽管在男性、年轻患者以及运动FIM评分>25的患者中观察到重症中风病例恢复良好。这一结果表明，发病后的前3个月应被视为强化康复的重要时间窗。
