From the NHS National Services Scotland, Edinburgh (I.M.D.).
NHS Lanarkshire Stroke MCN, Monklands Hospital, Airdrie, United Kingdom (M.B.).
Stroke. 2019 May;50(5):1282-1285. doi: 10.1161/STROKEAHA.118.023916.
Background and Purpose- Home-time (HT) is a stroke outcome measure based on time spent at home after stroke. We hypothesized that HT assessment would be feasible and valid using national data. Methods- We linked the Scottish Stroke Care Audit to routine healthcare data and calculated 90-day HT for all strokes, 2005 to 2017. We described prognostic validity (Spearman rank correlation) of HT to baseline factors. Results- We were able to calculate HT for 101 969 strokes (99.3% of total Scottish strokes). Mean HT was 46 days (95% CI, 45.8-46.2; range, 0-90). HT showed consistent correlation with our prespecified prognostic factors: age: ρ, -0.35 (95% CI, -0.35 to -0.36); National Institutes of Health Stroke Scale score, -0.54 (95% CI, -0.52 to -0.55); and 6 simple variables (ordinal), -0.61 (95% CI, -0.61 to -0.62). Conclusions- HT can be derived at scale using routine clinical data and appears to be a valid proxy measure of functional recovery. Other national databases could use HT as a time and cost efficient measure of medium and longer-term outcomes.
背景与目的-家庭时间(HT)是一种基于卒中后在家时间的卒中结局测量指标。我们假设使用国家数据进行 HT 评估是可行和有效的。
方法-我们将苏格兰卒中护理审计与常规医疗保健数据相关联,并计算了 2005 年至 2017 年间所有卒中患者的 90 天 HT。我们描述了 HT 与基线因素的预后相关性(Spearman 秩相关)。
结果-我们能够计算出 101969 例卒中患者的 HT(占苏格兰卒中总数的 99.3%)。平均 HT 为 46 天(95%CI,45.8-46.2;范围,0-90)。HT 与我们预设的预后因素具有一致的相关性:年龄:ρ,-0.35(95%CI,-0.35 至 -0.36);国立卫生研究院卒中量表评分:-0.54(95%CI,-0.52 至 -0.55);以及 6 个简单变量(有序):-0.61(95%CI,-0.61 至 -0.62)。
结论-可以使用常规临床数据大规模得出 HT,并且它似乎是功能恢复的有效替代指标。其他国家数据库可以将 HT 用作中、长期结局的省时、省钱的衡量指标。