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生活质量:巴西公立医院脑卒中患者的预测因素和结局。

Quality of life: predictors and outcomes after stroke in a Brazilian public hospital.

机构信息

Universidade Federal do Paraná, Hospital de Clínicas, Unidade de AVC, Departamento de Clínica Médica, Curitiba PR, Brazil.

出版信息

Arq Neuropsiquiatr. 2023 Jan;81(1):2-8. doi: 10.1055/s-0042-1758364. Epub 2023 Mar 14.

Abstract

BACKGROUND

Some scales are applied after stroke to measure functional independence but qualify of life (QoL) is sometimes neglected in this scenario.

OBJECTIVE

To analyze predictors and outcomes of QoL after stroke using a validated scale in our population.

METHODS

Our study included patients who had their first ischemic stroke and were followed in the outpatient clinic for at least 6 months from stroke index. Disability status was assessed using the modified Rankin scale (mRS), the Barthel index (BI), and the Lawton and Brody scale. Quality of life was assessed by a stroke-specific QoL (SSQoL) scale. Statistical significance was accepted for  < 0.05. The estimated measure of association was the odds ratio (OR) for which 95% confidence intervals (95%Cis) were presented.

RESULTS

Of 196 patients studied, the median age was 60.4 (±13.4) years, and 89 (45.40%) of the patients were female. In a stepwise model considering risk factors, basic activities of daily living scales, satisfaction with life, and outcomes, we found four independent variables related to a poor QoL after stroke, namely hypertension, non-regular rehabilitation, not returning to work, and medical complications. The National Institutes of Health stroke scale (NIHSS) score at admission ≥ 9 was also an independent clinical marker. Approximately 30% of all participants had a negative score under 147 points in the SSQoL.

CONCLUSIONS

Our results showed that QoL after stroke in a developing country did not seem to differ from those of other countries, although there is a gap in rehabilitation programs in our public system. The functional scales are important tools, but they have failed to predict QoL, in some patients, when compared with specific scales.

摘要

背景

有些量表用于评估中风后的功能独立性,但在这种情况下,生活质量(QoL)有时会被忽视。

目的

使用我们人群中经过验证的量表分析中风后 QoL 的预测因素和结果。

方法

我们的研究包括首次发生缺血性中风的患者,且在中风指数后至少 6 个月在门诊接受随访。残疾状况使用改良 Rankin 量表(mRS)、Barthel 指数(BI)和 Lawton 和 Brody 量表进行评估。使用特定于中风的 QoL(SSQoL)量表评估生活质量。接受 < 0.05 为统计学意义。估计的关联度量为优势比(OR),并给出了 95%置信区间(95%Cis)。

结果

在 196 名研究患者中,中位数年龄为 60.4(±13.4)岁,89 名(45.40%)患者为女性。在考虑危险因素、基本日常生活活动量表、生活满意度和结局的逐步模型中,我们发现了与中风后 QoL 较差相关的四个独立变量,即高血压、非定期康复、无法重返工作岗位和医疗并发症。入院时 NIHSS 评分≥9 也是独立的临床标志物。大约 30%的参与者在 SSQoL 中得分低于 147 分。

结论

我们的结果表明,发展中国家中风后的 QoL 似乎与其他国家没有差异,尽管我们的公共系统中的康复计划存在差距。功能量表是重要的工具,但与特定量表相比,它们在某些患者中未能预测 QoL。

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Stroke is still a neglected disease in Brazil.在巴西,中风仍然是一种被忽视的疾病。
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