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住院亚急性卒中患者中跌倒者的临床特征:一项观察性队列研究。

Clinical features of fallers among inpatient subacute stroke: an observational cohort study.

作者信息

Morone Giovanni, Martino Cinnera Alex, Paolucci Teresa, Beatriz Henson Dianne Reyes, Paolucci Stefano, Iosa Marco

机构信息

Clinical Laboratory of Experimental Neurorehabilitation, IRCCS Santa Lucia Foundation, Via Ardeatina, 306, 00179, Rome, Italy.

Neurorehabilitation Unit F, IRCCS Santa Lucia Foundation, via Ardeatina 354, 00142, Roma, Italy.

出版信息

Neurol Sci. 2020 Sep;41(9):2599-2604. doi: 10.1007/s10072-020-04352-2. Epub 2020 Apr 7.

Abstract

BACKGROUND AND PURPOSE

The aim of this study is to observe the differences between fallers, common fallers, and non-fallers in stroke patients compared with the global ability in a rehabilitation setting.

MATERIALS AND METHODS

An observational and prospective study has been carried out. A total of 476 subacute stroke patients have been observed. The main outcome measures were assessed using the Canadian Neurological Scale (CNS), Barthel Index (BI), Functional Ambulatory Category (FAC), and Trunk Control Test (TCT) at admission to the rehabilitation unit and after 90 days of the rehabilitation treatment (nearly 3 h for day for 5 days for week) at the discharge with intermediate evaluations after the first and second months.

RESULTS

Out of 397 patients, 109 reported 1 or more falls (27.5%), of whom 67 fell 1 time (fallers) in the hospital (16.9%) and 42 fell 2 or more times (common fallers) (10.6%). For fallers, BI and FAC scores had a significant effect (p = 0.003 for both). Common fallers had statistically significant differences in BI (p = 0.002), FAC (p = 0.012), and TCT scores (0.023) compared with non-fallers.

CONCLUSIONS

The severity of stroke may directly increase the risk of fall, and also indirectly, lengthening the hospitalization. Our study seems to suggest that patients with BI scores of between 21 and 30 on admission are more prone to fall in the first period of hospitalization, whereas in the second month, those with scores of between 11 and 20 on admission have a higher risk of falls. In the third month, patients with BI scores below 10 on admission are more susceptible to falls.

摘要

背景与目的

本研究旨在观察脑卒中患者中跌倒者、频繁跌倒者与未跌倒者在康复环境下与整体能力的差异。

材料与方法

开展了一项观察性前瞻性研究。共观察了476例亚急性脑卒中患者。主要结局指标在康复单元入院时以及康复治疗90天(每周5天,每天近3小时)出院时,使用加拿大神经功能量表(CNS)、巴氏指数(BI)、功能性步行分类(FAC)和躯干控制测试(TCT)进行评估,在第一个月和第二个月后进行中期评估。

结果

在397例患者中,109例报告有1次或更多次跌倒(27.5%),其中67例在医院跌倒1次(跌倒者)(16.9%),42例跌倒2次或更多次(频繁跌倒者)(10.6%)。对于跌倒者,BI和FAC评分有显著影响(两者p值均为0.003)。与未跌倒者相比,频繁跌倒者在BI(p = 0.002)、FAC(p = 0.012)和TCT评分(0.023)方面有统计学显著差异。

结论

脑卒中的严重程度可能直接增加跌倒风险,也可能间接延长住院时间。我们的研究似乎表明,入院时BI评分为21至30分的患者在住院初期更容易跌倒,而在第二个月,入院时评分为11至20分的患者跌倒风险更高。在第三个月,入院时BI评分低于10分的患者更容易跌倒。

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