Kim Byoung-Joon, Hong Yeon Ran, Han Youngmin, Hwang Yang-Ha, Ohk Boram, Park Jaechan
Department of Neurosurgery, Kyungpook National University, Daegu, Republic of Korea.
Department of Nursing, Sunchon National University, Suncheon, Republic of Korea.
World Neurosurg. 2018 Jun;114:e51-e59. doi: 10.1016/j.wneu.2018.02.050. Epub 2018 Feb 16.
To investigate patient attitudes toward acceptable levels of disability after decompressive surgery for malignant middle cerebral artery infarction, including impact of patient age, to improve process of surgical informed consent.
Patients who had experienced a recent minor stroke were asked to complete a questionnaire containing 2 parts: demographic information, including patient age, sex, years of education, working status, religion, and economic status, and acceptable level of disability based on modified Rankin Scale (mRS) with corresponding illustrations to explain mRS levels.
Patient age was identified as an independent determinant of the worst acceptable mRS score with a negative correlation. For nondominant hemispheric malignant infarction, the worst acceptable mRS score was significantly lower (mean ± SD 2.0 ± 1.3) for the oldest patients (>70 years old) compared with patients <60 years old (mean ± SD 3.0 ± 0.6) and 60-70 years old (mean ± SD 3.0 ± 0.8). For dominant hemispheric malignant infarction with language impairment, all age groups showed a significantly lower value for worst acceptable mRS score (mean ± SD 1.8 ± 1.1 for patients <60 years old, 1.8 ± 1.2 for patients 60-70 years old, and 1.0 ± 1.4 for patients >70 years old).
Patients showed different attitudes toward disability according to their age. Patients >70 years old showed the lowest worst acceptable mRS score after surgical treatment of malignant infarction. Language impairment with dominant hemispheric infarction further decreased the worst acceptable mRS score.
探讨患者对大脑中动脉恶性梗死减压手术后可接受残疾水平的态度，包括患者年龄的影响，以改进手术知情同意过程。
要求近期发生轻度中风的患者完成一份包含两部分的问卷：人口统计学信息，包括患者年龄、性别、受教育年限、工作状态、宗教信仰和经济状况；以及基于改良Rankin量表（mRS）的可接受残疾水平，并配有相应插图以解释mRS水平。
患者年龄被确定为与最差可接受mRS评分呈负相关的独立决定因素。对于非优势半球恶性梗死，年龄最大的患者（>70岁）的最差可接受mRS评分（均值±标准差2.0±1.3）显著低于60岁以下患者（均值±标准差3.0±0.6）和60 - 70岁患者（均值±标准差3.0±0.8）。对于伴有语言障碍的优势半球恶性梗死，所有年龄组的最差可接受mRS评分均显著较低（60岁以下患者均值±标准差1.8±1.1，60 - 70岁患者均值±标准差1.8±1.2，70岁以上患者均值±标准差1.0±1.4）。
患者根据年龄对残疾表现出不同态度。70岁以上患者在恶性梗死手术治疗后最差可接受mRS评分最低。优势半球梗死伴语言障碍进一步降低了最差可接受mRS评分。
