Centre for Clinical Brain Sciences, The University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom..
Centre for Clinical Brain Sciences, The University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom.
J Stroke Cerebrovasc Dis. 2020 Aug;29(8):104993. doi: 10.1016/j.jstrokecerebrovasdis.2020.104993. Epub 2020 Jun 13.
If health professionals are to involve major stroke patients and their families in making decisions about treatments, they need to describe prognosis in terms that are easily understood. We suggest that referring to "specific abilities", such as ability to be independent, walk, talk, eat normally, be continent, live without severe pain, live without major anxiety or depression and to live at home may be more easily understood than terms such as disabled based on the modified Rankin scale (mRs).
We aimed to describe the "specific abilities" and quality of life of patients in each mRs level at six months after major stroke.
A longitudinal cohort study of patients admitted to hospital with major stroke with follow up at six months.
We recruited 403 patients, mean age 77.5yrs. The number (%) in each mRs level at six months was 0 (no problems): 8(2%), 1: 45(11.2%), 2: 7(1.7%), 3: 149(37.1%), 4: 46(11.4%), 5: 36(9.0%) and 6(dead) 111(27.6%). Patients within each mRs level varied with respect to their "specific abilities" and quality of life. For example, of the 36(9%) patients with mRs 5, 30(83%) could talk, 14(39%) were continent, 33(92%) were not in severe pain, 22(61%) did not have major anxiety/depression and 5(14%) could live at home. Their median utility (derived from HRQoL) was -0.08 (range -0.35 to 0.43).
Describing prognosis with the mRs does not convey the variation in specific abilities and HRQoL amongst patients with major stroke. Therefore, describing prognosis in terms of "specific abilities" may be more appropriate.
如果卫生专业人员要让大中风患者及其家属参与治疗决策，他们需要用易于理解的术语来描述预后。我们建议，提到“特定能力”，例如独立、行走、说话、正常进食、有便意、无严重疼痛、无重度焦虑或抑郁以及能够在家中生活的能力，可能比基于改良 Rankin 量表（mRs）的残疾术语更容易理解。
我们旨在描述大中风后六个月每个 mRs 水平的患者的“特定能力”和生活质量。
一项对因大中风住院的患者进行的纵向队列研究，随访时间为六个月。
我们招募了 403 名患者，平均年龄为 77.5 岁。六个月时每个 mRs 水平的患者数量（%）分别为：0（无问题）：8（2%）、1：45（11.2%）、2：7（1.7%）、3：149（37.1%）、4：46（11.4%）、5：36（9.0%）和 6（死亡）：111（27.6%）。每个 mRs 水平的患者在“特定能力”和生活质量方面存在差异。例如，在 mRs 5 的 36 名患者中，30 名（83%）可以说话，14 名（39%）有便意，33 名（92%）无严重疼痛，22 名（61%）无重度焦虑/抑郁，5 名（14%）可以在家中生活。他们的中位数效用（从 HRQoL 得出）为-0.08（范围-0.35 至 0.43）。
用 mRs 描述预后并不能传达大中风患者特定能力和 HRQoL 的变化。因此，用“特定能力”来描述预后可能更为合适。
