药物增减对亚急性脑卒中患者康复结局的影响。
Impacts of increases and decreases of drugs on rehabilitation outcomes of subacute stroke patients.
机构信息
Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan.
Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan.
出版信息
J Stroke Cerebrovasc Dis. 2023 Jul;32(7):107150. doi: 10.1016/j.jstrokecerebrovasdis.2023.107150. Epub 2023 Apr 27.
OBJECTIVE
To examine changes in drugs for subacute stroke patients and elucidate the impact of medications on rehabilitation outcomes.
MATERIALS AND METHODS
A total of 295 subacute stroke patients who were admitted to the convalescent rehabilitation ward between June 2018 and May 2019 were included. Polypharmacy was defined as five or more drugs at admission. The primary outcome was the Functional Independence Measure Total score (FIM-T) at discharge. Multiple regression analysis was performed to examine the relationships between the FIM-T at discharge and drug changes or other factors. This study was conducted in two stages. The first analysis included all stroke patients, and the second analysis included only stroke patients with polypharmacy.
RESULTS
On multiple regression analysis, the number of drugs at admission (β=-0.628) was associated with FIM-T at discharge of all stroke patients. Furthermore, the number of additional drugs during hospitalization (β=-1.964) was associated with FIM-T at discharge in the 176 stroke patients with polypharmacy.
CONCLUSION
This study suggested that the number of drugs at admission and the addition of drugs during hospitalization might have a negative impact on the rehabilitation outcomes of subacute stroke patients.
目的
考察亚急性脑卒中患者药物使用的变化情况，并阐明药物对康复结局的影响。
材料与方法
共纳入 295 例 2018 年 6 月至 2019 年 5 月入住康复病房的亚急性脑卒中患者。入院时使用 5 种或以上药物定义为药物使用种类多。主要结局指标为出院时的功能独立性测量（FIM）总评分。采用多元回归分析，考察出院时 FIM-T 与药物变化或其他因素之间的关系。本研究分两阶段进行。第一阶段分析纳入所有脑卒中患者，第二阶段分析仅纳入药物使用种类多的脑卒中患者。
结果
多元回归分析显示，所有脑卒中患者入院时药物种类数（β=-0.628）与出院时 FIM-T 相关，药物使用种类多的 176 例脑卒中患者住院期间加用药物种类数（β=-1.964）与出院时 FIM-T 相关。
结论
本研究提示入院时药物种类数和住院期间加用药物种类数可能对亚急性脑卒中患者的康复结局产生负面影响。
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