Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria.
J Stroke Cerebrovasc Dis. 2013 Nov;22(8):e381-7. doi: 10.1016/j.jstrokecerebrovasdis.2013.04.015. Epub 2013 May 13.
The factors impacting poststroke functional dependency have not been adequately explored in sub-Saharan Africa. This study examined the risk factors for functional dependency in a group of Nigerian African stroke survivors.
One hundred twenty-eight stroke survivors attending a tertiary general hospital in southwestern Nigeria were consecutively recruited and assessed for functional dependency using the modified Rankin Scale (mRS). Stroke was diagnosed according to the World Health Organization criteria. Candidate independent variables assessed included the demographic and clinical characteristics of survivors, cognitive dysfunction, and a diagnosis of major depressive disorder. Variables with significant relationship to functional dependency were entered into a logistic regression model to identify factors that were predictive of functional dependency among the stroke survivors.
In all, 60.9% of the stroke survivors were functionally dependent (mRS scores≥3), with mean±SD mRS scores of 2.71±1.01. Female sex (P=.003; odds ratio [OR] 3.08; 95% confidence interval [CI] 1.47-6.44), global cognitive dysfunction (P=.002; OR 5.04; 95% CI 1.79-14.16), and major depressive disorder (P<.0001; OR 3.06; 95% CI 1.92-4.87) were strongly associated with functional dependency in univariate analysis. Major depressive disorder was an independent predictor of functional dependency in multivariate analysis (P<.0001; OR 6.89; 95% CI 2.55-18.6; R2=0.19).
Depression, female sex, and cognitive dysfunction were strongly associated with poorer functioning after stroke. Interventions aimed at depression and cognitive dysfunction after stroke may improve functional independence in stroke survivors.
在撒哈拉以南非洲地区，影响卒中后功能依赖的因素尚未得到充分探讨。本研究旨在调查一组尼日利亚非洲卒中幸存者的功能依赖的危险因素。
连续招募了 128 名在尼日利亚西南部一家三级综合医院就诊的卒中幸存者，并使用改良 Rankin 量表（mRS）评估其功能依赖程度。卒中的诊断依据世界卫生组织标准。评估的候选独立变量包括幸存者的人口统计学和临床特征、认知功能障碍和重度抑郁障碍的诊断。与功能依赖有显著关系的变量被纳入逻辑回归模型，以确定对卒中幸存者的功能依赖有预测作用的因素。
所有卒中幸存者中，有 60.9%（mRS 评分≥3）功能依赖，平均 mRS 评分为 2.71±1.01。女性（P=.003；比值比[OR] 3.08；95%置信区间[CI] 1.47-6.44）、整体认知功能障碍（P=.002；OR 5.04；95% CI 1.79-14.16）和重度抑郁障碍（P<.0001；OR 3.06；95% CI 1.92-4.87）在单变量分析中与功能依赖密切相关。在多变量分析中，重度抑郁障碍是功能依赖的独立预测因子（P<.0001；OR 6.89；95% CI 2.55-18.6；R2=0.19）。
抑郁、女性和认知功能障碍与卒中后功能恢复不良密切相关。针对卒中后抑郁和认知功能障碍的干预措施可能会提高卒中幸存者的功能独立性。
