Department of Neurology, University of Alabama Birmingham, Birmingham, AL.
School of Medicine, Rosalind Franklin University, Chicago, IL.
Arch Phys Med Rehabil. 2019 Mar;100(3):481-487.e2. doi: 10.1016/j.apmr.2018.06.007. Epub 2018 Jul 4.
To evaluate the association between functional measures at admission to acute inpatient rehabilitation (AIR) and health-related quality of life (HRQOL) scores at 3 months after ischemic stroke.
Consecutive patients with ischemic stroke admitted to AIR were consented to a prospective registry.
Large academic referral inpatient rehabilitation hospital.
Patients (N=113) with ischemic stroke (mean age 70.6 ± 14.5y; 54.0% male; 56.6% white) were included in the analysis.
Not applicable.
Admission FIM and Berg Balance Scores (BBS) were abstracted when available. The Neuro-Quality of Life questionnaire was used to assess 3-month HRQOL in 4 domains: upper extremity (UE), lower extremity (LE), executive functions (EF), and general concerns (GC). Associations of FIM and BBS scores with impaired HRQOL at 3 months were evaluated.
The median time from stroke onset to admission FIM and BBS was 6.4 (interquartile range [IQR] 4.2-11.3) and 8.9 (IQR 5.8-14.4) days, respectively. A 5-point increase in admission FIM score decreased the likelihood of impairment in HRQOL at 3 months by 25% for GC (odds ratio [OR] 0.75, 95% confidence interval [CI] 0.61-0.93, P=.01), 31% for EF (OR 0.69, 95% CI 0.56-0.85, P=.001), 16% for UE function (OR 0.84, 95% CI 0.73-0.96, P=.01), and 21% for LE function (OR 0.79, 95% CI 0.67-0.93 P=.004). A 5-point increase in admission BBS decreased the likelihood of impairment in HRQOL domains at 3 months by 15% for UE function (OR 0.85, 95% CI 0.75-0.98, P=.02) and 25% for LE function (OR 0.75, 95% CI 0.64-0.89, P=.001).
Admission FIM and BBS were strongly associated with 3-month HRQOL associated across multiple domains following stroke. These findings indicate that HRQOL can be predicted earlier in a patient's course during AIR.
评估急性住院康复（AIR）入院时的功能测量与缺血性脑卒中后 3 个月的健康相关生活质量（HRQOL）评分之间的关联。
连续纳入同意参加前瞻性登记的缺血性脑卒中患者。
大型学术转诊住院康复医院。
分析纳入了 113 名缺血性脑卒中患者（平均年龄 70.6±14.5 岁；54.0%为男性；56.6%为白人）。
无。
入院时的功能独立性评定量表（FIM）和伯格平衡量表（BBS）可根据需要进行提取。使用神经生活质量问卷评估 4 个领域的 3 个月 HRQOL：上肢（UE）、下肢（LE）、执行功能（EF）和一般关注（GC）。评估入院时的 FIM 和 BBS 评分与 3 个月时 HRQOL 受损之间的关联。
从脑卒中发病到入院 FIM 和 BBS 的中位数时间分别为 6.4（四分位距 [IQR] 4.2-11.3）和 8.9（IQR 5.8-14.4）天。入院时 FIM 评分增加 5 分，GC 的 HRQOL 受损可能性降低 25%（优势比 [OR] 0.75，95%置信区间 [CI] 0.61-0.93，P=.01），EF 降低 31%（OR 0.69，95% CI 0.56-0.85，P=.001），UE 功能降低 16%（OR 0.84，95% CI 0.73-0.96，P=.01），LE 功能降低 21%（OR 0.79，95% CI 0.67-0.93，P=.004）。入院时 BBS 增加 5 分，UE 功能 HRQOL 受损的可能性降低 15%（OR 0.85，95% CI 0.75-0.98，P=.02），LE 功能降低 25%（OR 0.75，95% CI 0.64-0.89，P=.001）。
入院时的 FIM 和 BBS 与脑卒中后多个领域的 3 个月 HRQOL 密切相关。这些发现表明，HRQOL 可以在患者 AIR 期间的病程早期进行预测。
