心脏骤停后评估：脑功能预后评分的结构效度。
Measuring outcome after cardiac arrest: construct validity of Cerebral Performance Category.
机构信息
Adelante, Centre of Expertise in Rehabilitation and Audiology, Zandbergsweg 111, 6432 CC Hoensbroek, The Netherlands; Revant Rehabilitation Centre Breda, Brabantlaan 1, 4817 JW Breda, The Netherlands.
Adelante, Centre of Expertise in Rehabilitation and Audiology, Zandbergsweg 111, 6432 CC Hoensbroek, The Netherlands; CAPHRI School for Public Health and Primary Care, Department of Rehabilitation Medicine, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands.
出版信息
Resuscitation. 2016 Mar;100:6-10. doi: 10.1016/j.resuscitation.2015.12.005. Epub 2015 Dec 29.
INTRODUCTION
Approximately half of the survivors of cardiac arrest have cognitive impairments due to hypoxic brain injury. To describe the outcome after a cardiac arrest, the Cerebral Performance Category (CPC) is frequently used. Although widely used, its validity is still debatable.
OBJECTIVE
To investigate the construct validity of the Cerebral Performance Category in survivors of a cardiac arrest. Participants were 18 years and older that survived a cardiac arrest more than six months.
METHODS
Cross-sectional design. A method to administer the CPC in a structured and reproducible manner was developed. This 'Structured CPC' was administered by a structured interview. Construct variables were Cognitive Failure Questionnaire (CFQ), Barthel Index (BI), Frenchay Activity Index (FAI), Community Integration Questionnaire (CIQ) and Quality of Life after Brain Injury (Qolibri). Associations were tested based on Spearman correlation coefficients.
RESULTS
A total of 62 participants responded. In 58 (94%) patients the CPC was determined, resulting in CPC 1 (48%), CPC 2 (23%) and CPC 3 (23%). The CPC-scoring correlated significantly with the CFQ (r=-0.40); BI (r=-0.57); FAI (r=-0.65), CIQ (r=-0.53) and Qolibri (r=-0.67).
DISCUSSION AND CONCLUSIONS
In this study we developed the 'Structured CPC' to improve the transparency and reproducibility of the original CPC. A moderate correlation between the 'Structured CPC' and the constructs 'activities', 'participation' and 'quality of life' confirmed the validity of the 'Structured CPC'.
CLINICAL MESSAGE
The 'Structured CPC' can be used as an instrument to measure the level of functioning after cardiac arrest.
简介
约有一半的心脏骤停幸存者会因缺氧性脑损伤而出现认知障碍。为了描述心脏骤停后的结果，常使用脑功能预后评分（Cerebral Performance Category，CPC）。尽管该评分被广泛应用，但它的有效性仍存在争议。
目的
研究心脏骤停幸存者的脑功能预后评分的结构效度。研究对象为心脏骤停后存活时间超过 6 个月且年龄在 18 岁及以上的患者。
方法
采用横断面设计。开发了一种结构化、可重复的脑功能预后评分方法，即“结构化脑功能预后评分”。该评分通过结构化访谈进行评估。结构变量包括认知失败问卷（Cognitive Failure Questionnaire，CFQ）、巴氏指数（Barthel Index，BI）、法国活动指数（Frenchay Activity Index，FAI）、社区融入问卷（Community Integration Questionnaire，CIQ）和脑损伤后生活质量问卷（Quality of Life after Brain Injury，Qolibri）。采用 Spearman 相关系数检验相关性。
结果
共 62 名患者做出了回应。58 名（94%）患者的脑功能预后评分结果为 CPC1（48%）、CPC2（23%）和 CPC3（23%）。CPC 评分与 CFQ（r=-0.40）、BI（r=-0.57）、FAI（r=-0.65）、CIQ（r=-0.53）和 Qolibri（r=-0.67）均呈显著相关。
讨论和结论
本研究开发了“结构化脑功能预后评分”，以提高原始脑功能预后评分的透明度和可重复性。“结构化脑功能预后评分”与“活动”、“参与”和“生活质量”等结构变量之间存在中度相关性，证实了“结构化脑功能预后评分”的有效性。
临床意义
“结构化脑功能预后评分”可作为评估心脏骤停后功能水平的工具。
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