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合并症对缺血性中风后康复结局的影响。

The Impact of Comorbidity on Rehabilitation Outcome after Ischemic Stroke.

作者信息

Simić-Panić Dušica, Bošković Ksenija, Milićević Marija, Rabi Žikić Tamara, Cvjetković Bošnjak Mina, Tomašević-Todorović Snežana, Jovićević Mirjana

机构信息

Faculty of Medicine, University of Novi Sad, Department of Medical Rehabilitation, Clinical Center of Vojvodina, Novi Sad, Serbia.

Department of Neurology, Clinical Center of Vojvodina, Novi Sad, Serbia.

出版信息

Acta Clin Croat. 2018 Mar;57(1):5-15. doi: 10.20471/acc.2018.57.01.01.

Abstract

Comorbidity decreases survival but it still remains unknown to what extent functional recovery after ischemic stroke is affected. The aim of this research was to determine the prevalence of the most common comorbidities in patients with ischemic stroke and to examine their predictive value on the functional status and recovery. In order to obtain relevant information for this research, we conducted a prospective study over a two-year period. It included patients with acute/subacute ischemic stroke who had inhospital rehabilitation treatment in our institution. Functional status of the patients was evaluated by the following three aspects at the beginning and at the end of rehabilitation treatment: Rivermead Mobility Index was used for mobility, Barthel Index for independence in activities of daily living, and modified Rankin Scale for total disability. Modified Charlston Comorbidity Index was used to assess comorbidity. Multivariate analysis was applied to evaluate the impact of recorded comorbidities on the patient functional outcome. Independent predictors of rehabilitation success in our study were the value of modified Charlston Comorbidity Index, atrial fibrillation and myocardial infarction. Our study demonstrated that patients with more comorbidities had worse functional outcome after stroke, so it is important to consider the comorbidity status when planning the rehabilitation treatment.

摘要

合并症会降低生存率,但缺血性中风后功能恢复受影响的程度仍不清楚。本研究的目的是确定缺血性中风患者中最常见合并症的患病率,并检验它们对功能状态和恢复情况的预测价值。为了获取本研究的相关信息,我们进行了一项为期两年的前瞻性研究。研究对象包括在我们机构接受住院康复治疗的急性/亚急性缺血性中风患者。在康复治疗开始时和结束时,从以下三个方面评估患者的功能状态:使用Rivermead活动指数评估活动能力,使用巴氏指数评估日常生活活动的独立性,使用改良Rankin量表评估总体残疾程度。使用改良Charlson合并症指数评估合并症。采用多变量分析来评估所记录的合并症对患者功能结局的影响。在我们的研究中,康复成功的独立预测因素是改良Charlson合并症指数的值、心房颤动和心肌梗死。我们的研究表明,合并症较多的患者中风后的功能结局较差,因此在规划康复治疗时考虑合并症状态很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70fd/6400340/2eb5e2f0d6df/acc-57-5-f1.jpg

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