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吸烟对脑血管病患者卒中严重程度、残疾、住院时间和死亡率的预后影响的队列研究。

The prognostic effect of cigarette smoking on stroke severity, disability, length of stay in hospital, and mortality in a cohort with cerebrovascular disease.

机构信息

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

出版信息

J Stroke Cerebrovasc Dis. 2013 Nov;22(8):e446-54. doi: 10.1016/j.jstrokecerebrovasdis.2013.05.001. Epub 2013 Jun 10.

Abstract

OBJECTIVE

The aim of this study was to determine the prognostic influence of cigarette smoking on stroke severity, disability, length of stay (LOS) in hospital, and mortality in different stroke types.

METHODS

A cohort separated by smoking status from the Registry of the Canadian Stroke Network was analyzed using logistic regression while controlling for key outcomes and clinical and demographic characteristics.

RESULTS

There were 20,523 patients that were included for this study from July 2003 to March 2008. Multivariable analyses revealed that, in general, long-time smoking had a negative effect on functional outcome at discharge, mortality at 1 year, and LOS in hospital. In general, former smoking had a positive impact in reducing the risk of severe stroke, mortality risk at 30 days, and the LOS in hospital. Significant differences in clinical and demographics were found between smokers, nonsmokers, and former smokers with cerebrovascular disease. On average, smokers had an earlier initial stroke presentation of cerebrovascular disease.

CONCLUSIONS

Our results provide empirical evidence regarding the prognostic influence of cigarette smoking on stroke severity, disability, and LOS in hospital and mortality, but the magnitude of the effect varied by stroke type.

摘要

目的

本研究旨在确定吸烟对不同类型中风严重程度、残疾、住院时间(LOS)和死亡率的预后影响。

方法

对加拿大中风网络注册处按吸烟状况分组的队列进行分析,采用逻辑回归,同时控制关键结局和临床及人口统计学特征。

结果

本研究纳入了 2003 年 7 月至 2008 年 3 月的 20523 例患者。多变量分析显示,长期吸烟对出院时的功能结局、1 年死亡率和住院 LOS 有负面影响。总体而言,既往吸烟对降低重度中风、30 天死亡率和住院 LOS 的风险有积极影响。在患有脑血管病的吸烟者、不吸烟者和既往吸烟者之间发现了显著的临床和人口统计学差异。吸烟者平均更早地出现脑血管病的首发症状。

结论

我们的结果提供了关于吸烟对中风严重程度、残疾和住院 LOS 以及死亡率的预后影响的经验证据,但影响的程度因中风类型而异。

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