MORe PREcISE 研究：一项多中心前瞻性研究卒中发病率患者报告结局测量指标：一项横断面研究。
MORe PREcISE: a multicentre prospective study of patient reported outcome measures in stroke morbidity: a cross sectional study.
机构信息
Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK.
出版信息
BMC Neurol. 2022 Apr 20;22(1):145. doi: 10.1186/s12883-022-02634-0.
BACKGROUND AND PURPOSE
The use of patient reported outcomes measures (PROMs) may offer utility that are important for stroke survivors. This study assessed the PROMIS-10, which contains Mental health (MH) and Physical Health (PH) domains, with an additional five stroke specific questions. The aim of this study was to evaluate the association between the MH and PH measures following a stroke and pre-existing health conditions.
METHODS
A multicentre prospective cohort study at 19 hospital sites across England and Wales during 2019 was conducted. The association between each PROMIS-10 domain and demographic and health conditions were calculated using a multilevel multivariable linear and present the adjusted mean difference (aMD).
RESULTS
The study enrolled 549 stroke survivors within 14 days of the index event, 232 were women (42.3%) and with a mean age of 72.7 years (SD = 12.9, range 25 to 97). The MH domain was scored as poor in 3.9% of participants, and very good or excellent in almost a half (48.4%). In contrast the PH domain was scored as poor in 39.9%, compared to very good or excellent in 8.5%. The MH domain was associated with pre-existing diabetes (aMD = - 2.01; 95%CI -3.91, - 0.12; p = 0.04), previous stroke (aMD = - 3.62; 95%CI -5.86, - 1.39; p = 0.001), age (aMD = 0.07; 95%CI: 0.01, 0.14; p = 0.037), and female sex (aMD = 1.91; 95%CI 0.28, 3.54; p = 0.022). The PH domain was found to be associated with sex (female) (aMD = 2.09; 95%CI 0.54, 3.65; p = 0.008) and previous stroke (aMD = - 3.05; 95%CI -5.17, - 0.93; p = 0.005).
CONCLUSIONS
Almost half of stroke survivors reported poor PH using a PROM with less reporting poor MH. age, and sex were associated with both MH and PH domains, and additionally pre-exising diabetes and stroke were associated with poorer MH. Clinical management offers an opportunity to investigate and intervene to prevent long term poorer health in stroke survivors.
背景与目的
使用患者报告结局测量（PROMs）可能具有对脑卒中幸存者很重要的效用。本研究评估了包含心理健康（MH）和身体健康（PH）领域以及另外五个针对脑卒中的特定问题的 PROMIS-10。本研究的目的是评估脑卒中后以及先前健康状况与 MH 和 PH 测量之间的关联。
方法
在 2019 年期间，在英格兰和威尔士的 19 家医院进行了一项多中心前瞻性队列研究。使用多层次多变量线性方法计算了每个 PROMIS-10 域与人口统计学和健康状况之间的关联，并呈现了调整后的平均差异（aMD）。
结果
该研究纳入了 549 名脑卒中后 14 天内的幸存者，其中 232 名女性（42.3%），平均年龄为 72.7 岁（标准差=12.9，范围 25 至 97）。3.9%的参与者心理健康状况较差，而近一半（48.4%）的参与者心理健康状况非常好或优秀。相比之下，身体健康状况较差的参与者占 39.9%，而身体健康状况非常好或优秀的参与者仅占 8.5%。心理健康状况与先前存在的糖尿病（aMD=-2.01；95%CI -3.91, -0.12；p=0.04）、先前的脑卒中（aMD=-3.62；95%CI -5.86, -1.39；p=0.001）、年龄（aMD=0.07；95%CI：0.01, 0.14；p=0.037）和女性性别（aMD=1.91；95%CI 0.28, 3.54；p=0.022）有关。身体健康状况与性别（女性）（aMD=2.09；95%CI 0.54, 3.65；p=0.008）和先前的脑卒中（aMD=-3.05；95%CI -5.17, -0.93；p=0.005）有关。
结论
近一半的脑卒中幸存者使用 PROM 报告身体健康状况较差，而报告心理健康状况较差的比例较少。年龄和性别与 MH 和 PH 领域均有关联，此外，先前存在的糖尿病和脑卒中与较差的心理健康状况有关。临床管理提供了一个机会，可以调查和干预以预防脑卒中幸存者的长期健康状况恶化。
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