Riga Stradiņš University, Riga, Latvia.
Riga East University Hospital, Riga, Latvia.
Brain Behav. 2018 Dec;8(12):e01152. doi: 10.1002/brb3.1152. Epub 2018 Nov 12.
The aim of this study was to evaluate how pre-stroke risk factors, neurological symptoms, and the level of disability shortly after stroke are associated with poststroke mortality during a 7-year period after stroke, for persons treated in a stroke unit.
The data of 231 patients were included in the study. Patients who were treated in the stroke unit at the Riga East University Hospital between February 1, 2009, and July 20, 2009, were included in this study. Three stepwise Cox proportional hazard analyses were performed to analyze mortality in the 7 years following stroke. Pre-stroke risk factors (type of stroke, arterial hypertension, diabetes mellitus, atrial fibrillation, smoking, alcohol abuse, obesity, recurrent stroke, age, gender), neurological symptoms (motor deficit, sensory disturbance, aphasia, poststroke urinary incontinence (PSUI), mental status), and limitations of activity (feeding, bathing, grooming, dressing, toilet use, transfers, mobility, stairs) were evaluated as factors associated with mortality after stroke.
A total of 145 (62.8%) patients died during the study period. The final model for each group of factors included only one of the factors used for the analysis. Patients who had alcohol abuse were 40% more likely to die earlier. The hazard for those with PSUI is 1.72 times higher than those without PSUI. The independence in grooming showed a 39% lower likelihood of dying earlier.
Alcohol abuse as a pre-stroke risk factor, poststroke urinary incontinence as a neurological symptom, and dependence in grooming as a factor of disability were associated with earlier mortality in the first seven years after stroke.
本研究旨在评估卒中单元治疗的患者,卒中前的危险因素、卒中后即刻的神经症状和残疾程度与卒中后 7 年内的死亡率之间的关系。
本研究纳入了 231 例患者。这些患者于 2009 年 2 月 1 日至 2009 年 7 月 20 日在里加东大学医院的卒中单元接受治疗。本研究采用逐步 Cox 比例风险分析方法,分析卒中后 7 年内的死亡率。卒中前的危险因素(卒中类型、动脉高血压、糖尿病、心房颤动、吸烟、酗酒、肥胖、复发性卒中、年龄、性别)、神经症状(运动缺陷、感觉障碍、失语症、卒中后尿失禁、精神状态)和活动受限(进食、洗浴、梳妆、穿衣、使用厕所、转移、移动、上下楼梯)被评估为与卒中后死亡率相关的因素。
在研究期间,共有 145 例(62.8%)患者死亡。每组因素的最终模型仅包含用于分析的因素之一。酗酒的患者更早死亡的风险增加 40%。有卒中后尿失禁的患者死亡风险是无卒中后尿失禁患者的 1.72 倍。在梳妆方面依赖的患者更早死亡的可能性降低 39%。
卒中前的危险因素酗酒、神经症状卒中后尿失禁以及残疾因素在梳妆方面的依赖与卒中后 7 年内的早期死亡率相关。