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采用 LCGA 方法对首次脑卒中幸存者的功能恢复轨迹和决定因素进行分析:基于医院的 1 年期间分析。

Differential trajectory of functional recovery and determinants for first time stroke survivors by using a LCGA approach: a hospital based analysis over a 1-year period.

机构信息

School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan -

出版信息

Eur J Phys Rehabil Med. 2013 Aug;49(4):463-72. Epub 2012 Nov 21.

Abstract

BACKGROUND

Functional outcome and the risk factors for stroke survivors have explored in previous study. However, a comprehensive understanding of the patterns and critical risk factors of functional recovery is limited.

AIM

To explore the trajectory groups and determinants of functional recovery for ischemic stroke patients during 1 year after stroke.

DESIGN

Longitudinal study.

SETTING

Inpatient.

POPULATION

First-time stroke patients.

METHOD

A total of 367 first-time ischemic stroke patients from the Stroke Registry in the Chang Gung Hospital (SRICH) database were analyzed in this study. Study variables comprised demographic and disease characteristics, laboratory data, and functional outcome. The Latent Class Growth Analysis (LCGA) was used to identify various trajectory clusters and multinomial logistic regression was used to identify the predictors of functional recovery.

RESULT

Five trajectory clusters of functional recovery were identified using the Barthel Index. Among five clusters of functional recovery, nearly 18% of first-ever ischemic stroke patients maintained functional dependence, whereas 82% of stroke patients demonstrated functional recovery; and the significant recovery time totaled three months after the stroke. Determinants for various trajectory clusters of functional recovery were body mass index and serum albumin level, especially a higher serum albumin concentration predicted a more favorable functional recovery.

CONCLUSION

Our findings suggest that diverse functional recovery clusters persisted and serum albumin concentration at admission was a critical assessment factor. CLINICAL REHABILITATION: Such information could be useful for identifying the different rehabilitation needs of varying trajectory groups and for effectively improving functional ability among the ischemic stroke population.

摘要

背景

之前的研究已经探讨了功能结果和中风幸存者的风险因素。然而,对于功能恢复的模式和关键风险因素,我们的理解还很有限。

目的

探索中风后 1 年内缺血性中风患者的功能恢复轨迹组和决定因素。

设计

纵向研究。

地点

住院部。

人群

首次中风患者。

方法

本研究分析了来自长庚医院中风登记处(SRICH)数据库的 367 名首次缺血性中风患者。研究变量包括人口统计学和疾病特征、实验室数据和功能结果。采用潜在类别增长分析(LCGA)识别各种轨迹簇,采用多项逻辑回归识别功能恢复的预测因素。

结果

采用 Barthel 指数识别出五种功能恢复轨迹簇。在五种功能恢复轨迹簇中,近 18%的首次缺血性中风患者保持功能依赖,而 82%的中风患者表现出功能恢复;显著恢复时间总计为中风后三个月。功能恢复轨迹簇的决定因素是体重指数和血清白蛋白水平,特别是较高的血清白蛋白浓度预示着更有利的功能恢复。

结论

我们的研究结果表明,存在不同的功能恢复轨迹簇,入院时的血清白蛋白浓度是一个关键的评估因素。临床康复:这些信息可用于识别不同轨迹组的不同康复需求,并有效提高缺血性中风人群的功能能力。

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