Vlachos Georgios, Ihle-Hansen Hege, Wyller Torgeir Bruun, Brækhus Anne, Mangset Margrete, Hamre Charlotta, Fure Brynjar
Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.
Department of Neurology, Oslo University Hospital, Oslo, Norway.
Arch Rehabil Res Clin Transl. 2022 Nov 12;5(1):100245. doi: 10.1016/j.arrct.2022.100245. eCollection 2023 Mar.
To evaluate prevalence and factors determining not returning to full-time work 1 year after first-ever mild ischemic stroke.
Prospective, observational cohort study with 12-month follow-up.
Stroke units and outpatient clinics at 2 Norwegian hospitals.
We included 84 (N=84) full-time working, cognitively healthy patients aged 70 years or younger who suffered an acute first-ever mild ischemic stroke, defined as National Institutes of Health Stroke Scale (NIHSS) score ≤3 points.
Not applicable.
Vascular risk factors, sociodemographic factors, stroke localization, and etiology were recorded at inclusion. Cognitive impairment, anxiety, depression, fatigue, and apathy 12 months after stroke were assessed with validated instruments. Logistic regression analyses were performed to find correlates of not returning to full-time employment.
Of 78 patients assessed 1 year after stroke, 63 (81%) had returned to work, 47 (60%) to full-time employment status. Modified Rankin scale score >1 (adjusted odds ratio, 12.44 [95% confidence interval, 2.37-65.43], =.003) at follow-up was significantly associated, and diabetes (adjusted odds ratio, 10.56 [95% confidence interval, 0.98-113.47], =.052) was borderline significantly associated with not returning to full-time work. Female sex, NIHSS at discharge, anxiety per point on the anxiety scale, depression per point on the depression scale, and fatigue per point on the fatigue scale were significantly associated with not returning to full-time work after 1 year, but these associations were only seen in the unadjusted models.
Low functional level that persists 12 months after stroke is related to not returning to full-time work. Patients with diabetes mellitus, female patients, and patients with a higher score on fatigue, anxiety, and depression scales may also be at risk of not returning to full-time work post stroke. Working patients should be followed up with a particular focus on factors determining participation in work and social life.
评估首次发生轻度缺血性卒中1年后未恢复全职工作的患病率及相关因素。
前瞻性观察性队列研究，随访12个月。
挪威2家医院的卒中单元和门诊诊所。
我们纳入了84名（N = 84）年龄在70岁及以下、全职工作且认知健康的患者，他们首次发生急性轻度缺血性卒中，定义为美国国立卫生研究院卒中量表（NIHSS）评分≤3分。
不适用。
纳入时记录血管危险因素、社会人口学因素、卒中部位和病因。卒中12个月后，使用经过验证的工具评估认知障碍、焦虑、抑郁、疲劳和淡漠情况。进行逻辑回归分析以找出未恢复全职工作的相关因素。
在卒中后1年评估的78名患者中，63名（81%）已恢复工作，47名（60%）恢复到全职工作状态。随访时改良Rankin量表评分>1（调整比值比，12.44 [95%置信区间，2.37 - 65.43]，P =.003）与未恢复全职工作显著相关，糖尿病（调整比值比，10.56 [95%置信区间，0.98 - 113.47]，P =.052）与未恢复全职工作存在边缘显著相关性。女性、出院时的NIHSS评分、焦虑量表上每增加1分的焦虑程度、抑郁量表上每增加1分的抑郁程度以及疲劳量表上每增加1分的疲劳程度与1年后未恢复全职工作显著相关，但这些关联仅在未调整模型中可见。
卒中后12个月仍持续存在的低功能水平与未恢复全职工作有关。糖尿病患者、女性患者以及在疲劳、焦虑和抑郁量表上得分较高的患者卒中后也可能有未恢复全职工作的风险。应对在职患者进行随访，特别关注决定其参与工作和社会生活的因素。
