LIGHT, Division of Biostatistics, University of Leeds, Leeds, UK,
Qual Life Res. 2014 Oct;23(8):2267-75. doi: 10.1007/s11136-014-0681-0. Epub 2014 Jun 10.
Understanding the heterogeneity in disability after stroke is important to guide treatment and rehabilitation planning. We explored mixture modelling analysis to identify subgroups of stroke disability and factors associated with disability subgroups.
Analyses were performed using secondary data from a cohort of 448 stroke patients who participated in a 2-year study of stroke outcomes. Mixture modelling approach was used to determine subgroups of early disability following stroke based on the Barthel Index, General Health Questionnaire (GHQ-28), Frenchay Activities Index and the Nottingham Extended Activities of Daily Living Scale.
Five distinct disability groups were identified. Nineteen (4.2%) patients were classified as having very severe disability, 58 (12.9%) severe disability, 133 (29.7%) moderate disability, 198 (44.2%) mild disability and 40 (8.9%) a mood disorder. Compared to the mild group, patients in the "very severe" group were more likely to be elderly and to have had a previous stroke, and less likely to live alone and had a greater risk of mortality 2 years after stroke. Patients in the mood disorder group showed greater dependency in activities of daily living were younger compared to the other groups and had a greater risk of having mood symptoms 2 years after stroke.
Mixture modelling of 1-month disability after stroke using a broad range of outcome measures has identified clinically meaningful groups relating to long-term outcomes.
了解卒中后残疾的异质性对于指导治疗和康复计划至关重要。我们探讨了混合模型分析，以确定卒中残疾亚组及与残疾亚组相关的因素。
对参加卒中结局 2 年研究的 448 例卒中患者的队列中的二级数据进行了分析。基于巴氏指数、一般健康问卷（GHQ-28）、法国活动指数和诺丁汉扩展日常生活活动量表，采用混合模型方法确定卒中后早期残疾的亚组。
确定了 5 个不同的残疾组。19 例（4.2%）患者被归类为严重残疾，58 例（12.9%）严重残疾，133 例（29.7%）中度残疾，198 例（44.2%）轻度残疾，40 例（8.9%）为情绪障碍。与轻度组相比，“非常严重”组的患者年龄较大，且更有可能有既往卒中，独居的可能性较小，卒中后 2 年的死亡率更高。与其他组相比，情绪障碍组的患者日常生活活动的依赖性更大，且更年轻，卒中后 2 年发生情绪症状的风险更高。
使用广泛的结局测量方法对卒中后 1 个月的残疾进行混合模型分析，确定了与长期结局相关的有临床意义的亚组。
