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远程卒中网络中的年龄分层与卒中严重程度

Age Stratification and Stroke Severity in the Telestroke Network.

作者信息

Simmons Cassie A, Poupore Nicolas, Nathaniel Thomas I

机构信息

Department of Biology, North Greenville University, Tigerville, SC 29688, USA.

School of Medicine Greenville, University of South Carolina, Greenville, SC 29605, USA.

出版信息

J Clin Med. 2023 Feb 14;12(4):1519. doi: 10.3390/jcm12041519.

Abstract

BACKGROUND

Age is one of the most important risk factors for stroke, and an estimated 75% of strokes occur in people 65 years old and above. Adults > 75 years of age experience more hospitalizations and higher mortality. In this study, we aimed to investigate how age and various clinical risk factors affect acute ischemic stroke (AIS) severity in two age categories.

METHODS

This retrospective data analysis study was conducted using data collected from the PRISMA Health Stroke Registry between June 2010 and July 2016. Baseline clinical and demographic data were analyzed for 65-74-year-old patients and those ≥ 75 years of age. .

RESULTS

An adjusted multivariate analysis showed that the acute ischemic stroke (AIS) population of 65-74-year-old patients experiencing heart failure (odds ratio (OR) = 4.398, 95% CI = 3.912-494.613, = 0.002) and elevated high-density lipoprotein (HDL) levels (OR = 1.066, 95% CI = 1.009-1.126, = 0.024) trended towards worsening neurological function, while patients experiencing obesity (OR = 0.177, 95% CI = 0.041-0.760, = 0.020) exhibited improved neurological functions. For the patients ≥ 75 years of age, direct admission (OR = 0.270, 95% CI = 0.085-0.856, = 0.026) was associated with improved functions.

CONCLUSIONS

Heart failure and elevated HDL levels were significantly associated with worsening neurologic functions in patients aged 65-74. Obese patients and individuals ≥ 75 years of age who were directly admitted were most likely to exhibit improving neurological functions.

摘要

背景

年龄是中风最重要的风险因素之一,估计75%的中风发生在65岁及以上的人群中。75岁以上的成年人住院次数更多,死亡率更高。在本研究中,我们旨在调查年龄和各种临床风险因素如何影响两个年龄组的急性缺血性中风(AIS)严重程度。

方法

本回顾性数据分析研究使用了2010年6月至2016年7月期间从PRISMA健康中风登记处收集的数据。对65 - 74岁患者和75岁及以上患者的基线临床和人口统计学数据进行了分析。

结果

一项调整后的多变量分析显示,65 - 74岁经历心力衰竭的急性缺血性中风(AIS)患者(优势比(OR)= 4.398,95%置信区间(CI)= 3.912 - 494.613,P = 0.002)和高密度脂蛋白(HDL)水平升高(OR = 1.066,95% CI = 1.009 - 1.126,P = 0.024)的患者神经功能有恶化趋势,而肥胖患者(OR = 0.177,95% CI = 0.041 - 0.760,P = 0.020)的神经功能有所改善。对于75岁及以上的患者,直接入院(OR = 0.270,95% CI = 0.085 - 0.856,P = 0.026)与功能改善相关。

结论

心力衰竭和HDL水平升高与65 - 74岁患者神经功能恶化显著相关。肥胖患者以及75岁及以上直接入院的患者最有可能表现出神经功能改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3484/9963120/a39decea7dfe/jcm-12-01519-g001.jpg

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