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首次脑卒中后 6 个月时功能水平和生活质量的预测因素:KOSCO 研究。

Predictors of functional level and quality of life at 6 months after a first-ever stroke: the KOSCO study.

机构信息

Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Seoul, Republic of Korea.

Department of Rehabilitation Medicine, School of Medicine, Chungnam National University, Daejeon, Republic of Korea.

出版信息

J Neurol. 2016 Jun;263(6):1166-77. doi: 10.1007/s00415-016-8119-y. Epub 2016 Apr 25.

Abstract

Predicting functional outcome and quality of life (QOL) is critical to the treatment of patients with stroke. The purpose of this study was to analyze the factors influencing functional status and QOL of stroke patients 6 months after a first-ever stroke. This study was an interim analysis of the Korean Stroke Cohort for Functioning and Rehabilitation Study, designed to include 10 years of follow-up for first-ever stroke patients. This study analyzed data from 2857 patients who completed face-to-face assessments with the functional independence measurement (FIM) and Euro Quality of Life-5D (EQ-5D) at 6 months after stroke onset. A multivariate regression analysis was used to analyze factors that potentially influenced FIM and EQ-5D results at 6 months after stroke. Of the patients in this study, 80.1 % suffered from ischemic stroke and 19.9 % experienced hemorrhagic stroke. The independent predictors of functional independency measured by FIM at 6 months after stroke were age, initial stroke severity, duration of hospitalization, and functional level at discharge in terms of motor, ambulation, and language. For QOL measured by EQ-5D at 6 months after stroke, age, duration of hospitalization, and motor function at discharge were significant predictors. In conclusion, proper treatment to achieve maximal functional gain at discharge may be an important factor in improving functional independency and QOL in chronic stage stroke survivors. These results provide useful information for establishing comprehensive and systematic care for stroke patients.

摘要

预测功能结局和生活质量(QOL)对于中风患者的治疗至关重要。本研究旨在分析影响首次中风后 6 个月中风患者功能状态和 QOL 的因素。本研究是韩国中风功能和康复研究队列的中期分析,旨在对首次中风患者进行 10 年的随访。本研究分析了 2857 名患者的数据,这些患者在中风发作后 6 个月完成了功能独立性测量(FIM)和欧洲生活质量-5D(EQ-5D)的面对面评估。使用多元回归分析来分析可能影响中风后 6 个月 FIM 和 EQ-5D 结果的因素。在本研究的患者中,80.1%患有缺血性中风,19.9%经历了出血性中风。6 个月后中风时 FIM 测量的功能独立性的独立预测因素是年龄、初始中风严重程度、住院时间以及出院时运动、行走和语言功能的功能水平。对于中风后 6 个月 EQ-5D 测量的 QOL,年龄、住院时间和出院时的运动功能是显著的预测因素。总之,出院时进行适当的治疗以实现最大的功能恢复可能是改善慢性期中风幸存者功能独立性和 QOL 的重要因素。这些结果为为中风患者提供全面系统的护理提供了有用的信息。

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