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卒中亚型对住院康复后恢复及功能结局的影响:因素的回顾性分析

The Impact of Stroke Subtype on Recovery and Functional Outcome after Inpatient Rehabilitation: A Retrospective Analysis of Factors.

作者信息

Ratha Krishnan Rathi, Yeo Edgar Quan Yi, Lim Chien Joo, Chua Karen Sui Geok

机构信息

Centre of Rehabilitation Excellence (CORE), Tan Tock Seng Hospital Rehabilitation Centre, Singapore 569766, Singapore.

Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore.

出版信息

Life (Basel). 2022 Aug 23;12(9):1295. doi: 10.3390/life12091295.


DOI:10.3390/life12091295
PMID:36143332
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9502826/
Abstract

The aims of this study were to compare inpatient rehabilitation outcomes between acute stroke subtypes of Cerebral Infarction (CI) and Intracerebral Hemorrhage (ICH), and to determine the predictors of discharge outcomes. A retrospective study of stroke inpatients was carried out using the discharge Functional Independence Measure (FIM) as the primary outcome measure. Relationships between stroke subtype, rehabilitation impairments, and medical complications on FIM -gain were analyzed. Altogether, 280 datasets including 211 (75.4%) CI and 69 (24.6%) ICH were analyzed. ICH patients were significantly younger than CI patients (55 years ICH vs. 64.0 years CI years, p < 0.001), had a 10-fold higher proportion needing ICU admission (ICH 82.6% vs. CI 7.6%, p < 0.001), and had significantly lower total admission FIM scores (67 points ICH vs. 74 CI points, p = 0.006), with lower motor-FIM scores in particular (38 points ICH vs. 48 points CI, p = 0.003). Significant functional improvements after inpatient rehabilitation, i.e., FIM gain, occurred regardless of stroke subtype (FIM-ICH Δ 27 vs. FIM-CI Δ 21, p = 0.05). Despite significantly worse initial stroke severity, ICH patients achieved similar functional gains, independence levels, and return-home rates compared with their CI counterparts after inpatient rehabilitation.

摘要

本研究的目的是比较脑梗死(CI)和脑出血(ICH)这两种急性卒中亚型的住院康复结局,并确定出院结局的预测因素。采用出院时功能独立性测量(FIM)作为主要结局指标,对卒中住院患者进行了一项回顾性研究。分析了卒中亚型、康复障碍和医疗并发症与FIM改善之间的关系。共分析了280个数据集,其中包括211例(75.4%)CI患者和69例(24.6%)ICH患者。ICH患者比CI患者明显年轻(ICH患者55岁,CI患者64.0岁,p<0.001),需要入住重症监护病房的比例高出10倍(ICH患者82.6%,CI患者7.6%,p<0.001),入院时FIM总分明显更低(ICH患者67分,CI患者74分,p=0.006),尤其是运动FIM评分更低(ICH患者38分,CI患者48分,p=0.003)。住院康复后出现了显著的功能改善,即FIM改善,无论卒中亚型如何(FIM-ICH增加27分,FIM-CI增加21分,p=0.05)。尽管初始卒中严重程度明显更差,但ICH患者在住院康复后与CI患者相比,在功能改善、独立水平和回家率方面取得了相似的结果。

相似文献

[1]
The Impact of Stroke Subtype on Recovery and Functional Outcome after Inpatient Rehabilitation: A Retrospective Analysis of Factors.

Life (Basel). 2022-8-23

[2]
Do stroke patients with intracerebral hemorrhage have a better functional outcome than patients with cerebral infarction?

PM R. 2009-5

[3]
Functional recovery following rehabilitation after hemorrhagic and ischemic stroke.

Arch Phys Med Rehabil. 2003-7

[4]
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[5]
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Arch Phys Med Rehabil. 2017-4

[6]
Postacute Rehabilitation Impact on Functional Recovery Outcome and Quality of Life in Stroke Survivors: Six Month Follow-Up.

Medicina (Kaunas). 2022-8-30

[7]
Impact of intracerebral hemorrhage and cerebral infarction on ADL and outcome in stroke patients: A retrospective cohort study.

NeuroRehabilitation. 2024

[8]
Revision of the predictive method improves precision in the prediction of stroke outcomes for patients admitted to rehabilitation hospitals.

J Phys Ther Sci. 2014-9

[9]
A Retrospective Cohort Comparing Left and Right Middle Cerebral Artery Ischemic Stroke Functional Outcomes in Acute Inpatient Rehabilitation.

PM R. 2021-7

[10]
Recovery and rehabilitation following subarachnoid haemorrhage. Part I: Outcome after inpatient rehabilitation.

Brain Inj. 1998-6

引用本文的文献

[1]
Editorial for the Special Issue "Physical Medicine and Rehabilitation: Trends and Applications".

Life (Basel). 2025-3-7

[2]
Intracranial Hemorrhage-Is Very Early Rehabilitation Safe? A Narrative Review.

J Clin Med. 2024-6-27

[3]
Upper limb sensorimotor recovery in Asian stroke survivors: a study protocol for the development and implementation of a Technology-Assisted dIgitaL biOmaRker (TAILOR) platform.

Front Neurol. 2023-11-30

[4]
Inpatient Rehabilitation Outcomes after Primary Severe Haemorrhagic Stroke: A Retrospective Study Comparing Surgical versus Non-Surgical Management.

Life (Basel). 2023-8-18

[5]
Stroke and the risk of gastrointestinal disorders: A Mendelian randomization study.

Front Neurol. 2023-2-21

本文引用的文献

[1]
Comparison between Ischemic and Hemorrhagic Strokes in Functional Outcome at Discharge from an Intensive Rehabilitation Hospital.

Diagnostics (Basel). 2020-12-28

[2]
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J Am Coll Cardiol. 2020-12-22

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The burden of neurological diseases in Europe: an analysis for the Global Burden of Disease Study 2017.

Lancet Public Health. 2020-10

[4]
Functional Recovery Patterns of Hemorrhagic and Ischemic Stroke Patients Under Post-Acute Care Rehabilitation Program.

Neuropsychiatr Dis Treat. 2020-8-13

[5]
Stroke Epidemiology in South, East, and South-East Asia: A Review.

J Stroke. 2017-9

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Comparison of outcomes after intracerebral hemorrhage and ischemic stroke.

J Stroke Cerebrovasc Dis. 2010-5

[7]
Hemorrhagic and ischemic strokes compared: stroke severity, mortality, and risk factors.

Stroke. 2009-6

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Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review.

Lancet Neurol. 2009-4

[9]
Burden of stroke in Singapore.

Int J Stroke. 2008-2

[10]
Results from a prospective acute inpatient rehabilitation database: clinical characteristics and functional outcomes using the Functional Independence Measure.

Ann Acad Med Singap. 2007-1

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