Yanagawa Youichi, Yoshihara Tomoyuki, Kato Hiroshi, Iba Toshiaki, Tanaka Hiroshi
Department of Emergency and Disaster Medicine, Juntendo University, Tokyo, Japan.
J Emerg Trauma Shock. 2013 Apr;6(2):83-6. doi: 10.4103/0974-2700.110750.
We retrospectively investigated prognostic factors including urinary incontinence on arrival among the patients with stroke.
A medical chart review was retrospectively performed for patients with stoke admitted between January 2010 and December 2010 in Ken-o Tokorozawa Hospital which had stroke care unit. The subjects were divided into a control group (functional outcome with modified Rankin scale (mRS) 0-3 at 3 months) and a poor group (severe disability or death, mRS 4-6).
There were 160 cases that had favorable outcome (the Control group) and 77 cases that had poor outcome (the Poor group). There were no significant differences between the two groups concerning the sex ratio, systolic blood pressure, heart rate, temperature, ratio of diabetes mellitus. However, the average age, ratio of hemorrhagic stroke, ratio of patients with a previous stroke, ratio of urinary incontinence upon admission, and duration of hospitalization in the Poor group was significantly higher than in the Control group. The Glasgow Coma Scale upon admission and ratio of hypertension in the Poor group were significantly lower than that in the Control group. Using a multiple logistic regression analysis, urinary incontinence (odds ratio, 3.17; 95% confidence interval, 1.45-6.93; P = 0.002), age (odds ratio, 1.04; 95% confidence interval, 1.01-1.07; P = 0.003) and Glasgow Coma Scale (odds ratio, 0.87; 95% confidence interval, 0.78-0.97; P = 0.01) were found to be factors independently associated with a poor outcome.
Among the patients with strokes, the presence of urinary incontinence on arrival, the old age, and the level of consciousness are important prognostic factors. Physicians should therefore check for these factors when evaluating a patient who has experienced a stroke or suspected stroke.
我们回顾性研究了卒中患者入院时包括尿失禁在内的预后因素。
对2010年1月至2010年12月在设有卒中护理单元的Ken-o所泽医院住院的卒中患者进行了回顾性病历审查。将研究对象分为对照组(3个月时改良Rankin量表(mRS)评分为0 - 3的功能结局)和不良组(严重残疾或死亡,mRS 4 - 6)。
有160例患者预后良好(对照组),77例患者预后不良(不良组)。两组在性别比例、收缩压、心率、体温、糖尿病比例方面无显著差异。然而,不良组的平均年龄、出血性卒中比例、既往有卒中病史的患者比例、入院时尿失禁比例以及住院时间均显著高于对照组。不良组入院时的格拉斯哥昏迷量表评分和高血压比例显著低于对照组。采用多因素逻辑回归分析发现,尿失禁(比值比,3.17;95%置信区间,1.45 - 6.93;P = 0.002)、年龄(比值比,1.04;95%置信区间,1.01 - 1.07;P = 0.003)和格拉斯哥昏迷量表评分(比值比,0.87;95%置信区间,0.78 - 0.97;P = 0.01)是与不良结局独立相关的因素。
在卒中患者中,入院时存在尿失禁、高龄和意识水平是重要的预后因素。因此,医生在评估卒中或疑似卒中患者时应检查这些因素。