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一项回顾性队列研究，旨在评估恶性大脑中动脉卒中减压性半颅骨切除术患者和医生报告的结局指标。

A Retrospective Cohort Study to Assess Patient and Physician Reported Outcome Measures After Decompressive Hemicraniectomy for Malignant Middle Cerebral Artery Stroke.

作者信息

Budhdeo Sanjay, Kolias Angelos G, Clark David J, Chari Aswin, Hutchinson Peter J, Warburton Elizabeth A

机构信息

Clinical Neurosciences, Addenbrooke's Hospital & University of Cambridge.

Division of Brain Sciences, Faculty of Medicine, Imperial College London.

出版信息

Cureus. 2017 May 10;9(5):e1237. doi: 10.7759/cureus.1237.

DOI:10.7759/cureus.1237
PMID:28620567
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5467774/
Abstract

INTRODUCTION

Decompressive hemicraniectomy for malignant middle cerebral artery (MCA) infarction is known to reduce mortality. However, there are on-going concerns in terms of the quality of life in survivors. We aimed to examine the correlation between patient and physician reported outcome measures in decompressive hemicraniectomy.

PATIENTS AND METHODS

We analyzed outcomes in 21 patients who underwent decompressive hemicraniectomy for malignant MCA infarction between September 2003 and August 2013 within a regional health system. Patient and physician reported outcome measures were collected at follow-up. These were Stroke Impact Scale (SIS) Version 3, modified Rankin Scale (mRS), National Hospital Seizure Severity Scale, Headache Impact Test and Patient Health Questionnaire for depression.

RESULTS

There was a good correlation between physician and patient reported outcome measures. The Spearman's rank correlation coefficient between mRS and structured SIS Version 3 was -0.887 (p < 0.001); with unstructured SIS results, the correlation coefficient was -0.663 (p = 0.001). There was no statistically significant correlation between life worth and modified Rankin Scale: r = -0.3383 (p = 0.087).

DISCUSSION

Our findings of a statistically significant correlation between mRS and SIS have not previously been reported in patients with this condition. These findings provide further information to inform patient and next of kin discussions regarding outcomes from decompressive hemicraniectomy in malignant MCA infarction.

摘要

引言

已知恶性大脑中动脉（MCA）梗死减压性颅骨切除术可降低死亡率。然而，幸存者的生活质量一直令人担忧。我们旨在研究减压性颅骨切除术中患者报告的结局指标与医生报告的结局指标之间的相关性。

患者与方法

我们分析了2003年9月至2013年8月期间在一个区域卫生系统内接受恶性MCA梗死减压性颅骨切除术的21例患者的结局。在随访时收集患者和医生报告的结局指标。这些指标包括卒中影响量表（SIS）第3版、改良Rankin量表（mRS）、国家医院癫痫严重程度量表、头痛影响测试和用于评估抑郁的患者健康问卷。

结果

医生报告的结局指标与患者报告的结局指标之间存在良好的相关性。mRS与结构化SIS第3版之间的Spearman等级相关系数为-0.887（p<0.001）；对于非结构化SIS结果，相关系数为-0.663（p=0.001）。生活价值与改良Rankin量表之间无统计学显著相关性：r=-0.3383（p=0.087）。

讨论

我们发现mRS与SIS之间存在统计学显著相关性，此前在患有这种疾病的患者中尚未有过相关报道。这些发现为患者及其家属关于恶性MCA梗死减压性颅骨切除术结局的讨论提供了更多信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/563d/5467774/e249a2ff7c62/cureus-0009-00000001237-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/563d/5467774/d85c20acb9e7/cureus-0009-00000001237-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/563d/5467774/32f45aaa08fb/cureus-0009-00000001237-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/563d/5467774/f2b717deffe7/cureus-0009-00000001237-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/563d/5467774/e249a2ff7c62/cureus-0009-00000001237-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/563d/5467774/d85c20acb9e7/cureus-0009-00000001237-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/563d/5467774/32f45aaa08fb/cureus-0009-00000001237-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/563d/5467774/f2b717deffe7/cureus-0009-00000001237-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/563d/5467774/e249a2ff7c62/cureus-0009-00000001237-i04.jpg

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