Yu Amy Y X, Rogers Edwin, Wang Meng, Sajobi Tolulope T, Coutts Shelagh B, Menon Bijoy K, Hill Michael D, Smith Eric E
From the Department of Clinical Neurosciences (A.Y.X.Y., M.W., T.T.S., S.B.C., B.K.M., M.D.H., E.E.S.), Department of Community Health Sciences (A.Y.X.Y., T.T.S., S.B.C., B.K.M., M.D.H., E.E.S.), Department of Radiology (S.B.C., B.K.M., M.D.H., E.E.S.), and Hotchkiss Brain Institute (T.T.S., S.B.C., B.K.M., M.D.H., E.E.S.), University of Calgary; and Alberta Health Services (E.R.), Calgary, Canada.
Neurology. 2017 Nov 7;89(19):1970-1976. doi: 10.1212/WNL.0000000000004631. Epub 2017 Oct 11.
To describe home-time, stratified by stroke type, in a complete population and to determine its correlation with modified Rankin Scale (mRS) scores.
We used linked administrative data to derive home-time in all patients admitted for a cerebrovascular event in Alberta, Canada, between 2012 and 2016. Home-time is the number of days spent outside a health institution in the first 90 days after index hospitalization. We used negative binomial regression, adjusted for age, sex, Charlson comorbidity index, and hospital location, to determine the association between home-time and stroke type. In 552 patients enrolled in 4 acute ischemic stroke clinical trials, we used multivariable ordinal logistic regression analysis to determine the association between home-time and mRS score at 90 days.
Among 15,644 patients (n = 10,428 with ischemic stroke, n = 1,415 with intracerebral hemorrhage, n = 760 with subarachnoid hemorrhage, n = 3,041 with TIA), patients with TIA have the longest home-time, almost triple the number of days at home compared to patients with intracerebral hemorrhage (incidence rate ratio 2.85, 95% confidence interval [CI] 2.58-3.15). Among clinical trial ischemic stroke patients, longer home-time was associated with a lower mRS score at 90 days (adjusted common odds ratio 1.04, 95% CI 1.04-1.05).
We showed that home-time is an objective and graded indicator that is correlated with disability after stroke. It is obtainable from administrative data, applicable to different stroke types, and a valuable outcome indicator in population-based health services research.
描述完整人群中按中风类型分层的居家时间，并确定其与改良Rankin量表（mRS）评分的相关性。
我们使用关联的行政数据，得出2012年至2016年期间加拿大艾伯塔省因脑血管事件入院的所有患者的居家时间。居家时间是指首次住院后前90天内在医疗机构外度过的天数。我们使用负二项回归，并对年龄、性别、Charlson合并症指数和医院位置进行了调整，以确定居家时间与中风类型之间的关联。在4项急性缺血性中风临床试验的552名患者中，我们使用多变量有序逻辑回归分析来确定居家时间与90天时mRS评分之间的关联。
在15644名患者中（缺血性中风患者n = 10428，脑出血患者n = 1415，蛛网膜下腔出血患者n = 760，短暂性脑缺血发作患者n = 3041），短暂性脑缺血发作患者的居家时间最长，与脑出血患者相比，居家天数几乎是其三倍（发病率比2.85，95%置信区间[CI] 2.58 - 3.15）。在临床试验的缺血性中风患者中，较长的居家时间与90天时较低的mRS评分相关（调整后的共同优势比1.04，95% CI 1.04 -
