Martínez-Betancur Octavio, Quintero-Cusguen Patricia, Mayor-Agredo Liliana
Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia,
Hospital Universitario de La Samaritana, Bogotá, Colombia.
Rev Salud Publica (Bogota). 2016 Apr;18(2):226-237. doi: 10.15446/rsap.v18n2.31692.
Objective To test the hypothesis that DALYs, estimated individually for each patient with acute ischemic stroke upon hospital discharge, without reperfusion therapy, are not different between the different subtypes of ischemic stroke. Patients and Methods In the Hospital Universitario de la Samaritana in Bogotá, the health records of patients diagnosed with their first acute ischemic stroke event from admission and monitoring to discharge were selected. The subtype of acute ischemic stroke was classified according to the criteria established by the Trial of Org 10172 in Acute Stroke Treatment (TOAST). DALYs were estimated for each patient with acute ischemic stroke at hospital discharge. To establish differences of DALYs among the five acute ischemic stroke subtypes (TOAST), the Kruskal Wallis test was used. Results Of the 39 cases of acute ischemic stroke, 17 (43.6 %) were classified as artherosclerosis, 10 (25.6 %) as lacunar events, 6 (15.4 %) as cardioembolic attacks, and another 6 (15.4 %) cases with unclear etiology. At hospital discharge, the estimated total DALYs provided by patients with acute ischemic stroke was 316.9 years, without statistically significant differences between the subtypes of ischemic stroke. At hospital discharge, the average of optimal years free of disability lost by a patient surviving an acute ischemic stroke was 8.12. Conclusion Non conclusive results are attributed to the concurrence of dissimilar acute clinical care processes and to the risk factors distributions, comorbidities and patient complications.
目的 检验以下假设：对于急性缺血性卒中患者，在未进行再灌注治疗的情况下，出院时单独估算的伤残调整生命年（DALYs）在不同亚型的缺血性卒中之间并无差异。患者与方法 在波哥大的萨马利亚纳大学医院，选取了从入院监测至出院诊断为首次急性缺血性卒中事件的患者的健康记录。急性缺血性卒中的亚型根据急性卒中治疗中Org 10172试验（TOAST）制定的标准进行分类。对每位急性缺血性卒中患者出院时的DALYs进行估算。为确定五种急性缺血性卒中亚型（TOAST）之间DALYs的差异，使用了Kruskal Wallis检验。结果 在39例急性缺血性卒中病例中，17例（43.6%）被分类为动脉粥样硬化型，10例（25.6%）为腔隙性事件，6例（15.4%）为心源性栓塞发作，另有6例（15.4%）病因不明。出院时，急性缺血性卒中患者的估算总DALYs为316.9年，缺血性卒中各亚型之间无统计学显著差异。出院时，急性缺血性卒中存活患者无残疾的最佳平均年数为8.12年。结论 不确定的结果归因于不同急性临床护理过程的同时存在以及风险因素分布、合并症和患者并发症。
