Malaeb Diana, Hallit Souheil, Al Harfany Hiba, Mansour Sara, Faugeras Frederic, Salameh Pascale, Hosseini Hassan
School of Pharmacy, Lebanese International University, Beirut, Lebanon.
Life Sciences and Health Department, Paris-Est Créteil University, Paris, France.
Stroke Res Treat. 2021 May 27;2021:5551558. doi: 10.1155/2021/5551558. eCollection 2021.
Stroke is a leading cause of death and disability in developed countries. The major factor affecting long-term survival other than age is the disability severity caused by stroke. The modified Rankin Scale (mRS) is a global functional endpoint measurement used in acute stroke to evaluate the degree of disability or dependence in daily life activities. The objective of this study was to assess the effects of sociodemographic factors, concomitant disease states, and some measures performed in the emergency department (ED) on patients' disability.
We conducted a retrospective study on ischemic stroke patients admitted to Intensive Care Unit of three Lebanese university hospitals between June and December 2016. Patients were excluded if they had been discharged from ED without hospital admission or if mRS was not performed. The mRS was further subdivided into two categories considered as "good prognosis" (0-2 or 0-3) and "poor prognosis" (>2 or > 3).
204 patients were included in the study with mean age of 65.4 ± 11.9 years, hypertension was the most previous concomitant past medical disease (77.1%), and 27.1% of these patients had previous history of stroke. No significant differences were found in both mRS categories for all sociodemographic factors, and past medical history except that arrhythmia was significantly more common in the higher mRS categories > 2 and > 3. Based on multivariable analysis, there was a trend for previous intake of calcium channel blocker to be associated with lower mRS at admission (beta -0.586). However, intracranial arterial stenosis, ED blood glucose > 180 mg/dL, and performing brain imaging above 20 minutes after patient presentation to ED were significantly associated with higher mRS scores at discharge with an ORa and (confidence interval) of 2.986 (0.814, 10.962), 3.301 (1.072, 1.261), and 1.138 (1.071, 9.080), respectively.
mRS is affected by previous disease states, prescribed medications, and acute measures performed in ED. It is also influenced by intracranial arterial stenosis etiology, which is associated with worse outcome.
在发达国家，中风是导致死亡和残疾的主要原因。除年龄外，影响长期生存的主要因素是中风所致的残疾严重程度。改良Rankin量表（mRS）是用于急性中风的一项整体功能终点指标，用以评估日常生活活动中的残疾或依赖程度。本研究的目的是评估社会人口统计学因素、伴随疾病状态以及在急诊科（ED）采取的一些措施对患者残疾情况的影响。
我们对2016年6月至12月期间入住黎巴嫩三所大学医院重症监护病房的缺血性中风患者进行了一项回顾性研究。如果患者未住院就从急诊科出院或未进行mRS评估，则将其排除。mRS进一步细分为两类，即“预后良好”（0 - 2或0 - 3）和“预后不良”（>2或>3）。
204例患者纳入本研究，平均年龄65.4±11.9岁，高血压是最常见的既往伴随疾病（77.1%），这些患者中有27.1%既往有中风病史。在所有社会人口统计学因素和既往病史中，除心律失常在mRS较高类别（>2和>3）中显著更常见外，mRS两类之间未发现显著差异。基于多变量分析，既往服用钙通道阻滞剂有在入院时mRS较低的趋势（β -0.586）。然而，颅内动脉狭窄、急诊科血糖>180mg/dL以及患者到急诊科后20分钟以上才进行脑部成像与出院时较高的mRS评分显著相关，其比值比（ORa）及（置信区间）分别为2.986（0.814，10.962）、3.301（1.072，1.261）和1.138（1.071，9.080）。
mRS受既往疾病状态、所开药物以及在急诊科采取的急性措施影响。它还受颅内动脉狭窄病因影响，这与较差的预后相关。
