Stroke Program, University of Michigan Medical School, 1500 E. Medical Center Drive, Ann Arbor, Michigan, MI, 48109-5855, USA.
BMC Neurol. 2023 Jun 20;23(1):238. doi: 10.1186/s12883-023-03262-y.
Regular medical follow-up after stroke is important to reduce the risk of post-stroke complications and hospital readmission. Little is known about the factors associated with stroke survivors not maintaining regular medical follow-up. We sought to quantify the prevalence and predictors of stroke survivors not maintaining regular medical follow-up over time.
We conducted a retrospective cohort study of stroke survivors in the National Health and Aging Trends Study (2011-2018), a national longitudinal sample of United States Medicare beneficiaries. Our primary outcome was not maintaining regular medical follow-up. We performed a cox regression to estimate predictors of not maintaining regular medical follow-up.
There were 1330 stroke survivors included, 150 of whom (11.3%) did not maintain regular medical follow-up. Stroke survivor characteristics associated with not maintaining regular medical follow-up included not having restrictions in social activities (HR 0.64, 95% CI 0.41, 1.01 for having restrictions in social activities compared to not having restrictions in social activities), greater limitations in self-care activities (HR 1.13, 95% CI 1.03, 1.23), and probable dementia (HR 2.23, 95% CI 1.42, 3.49 compared to no dementia).
The majority of stroke survivors maintain regular medical follow-up over time. Strategies to retain stroke survivors in regular medical follow-up should be directed towards stroke survivors who do not have restrictions in social activity participation, those with greater limitations in self-care activities, and those with probable dementia.
定期进行中风后的医学随访对于降低中风后并发症和再住院的风险非常重要。然而，我们对于哪些因素与中风幸存者未能定期进行医学随访相关知之甚少。我们旨在量化随时间推移，中风幸存者未能定期进行医学随访的流行率和预测因素。
我们对美国医疗保险受益人的全国性纵向样本国家健康与老龄化趋势研究（2011-2018 年）中的中风幸存者进行了回顾性队列研究。我们的主要结局是未定期进行医学随访。我们进行了 Cox 回归分析，以估计未定期进行医学随访的预测因素。
共有 1330 名中风幸存者入选，其中 150 名（11.3%）未定期进行医学随访。与定期进行医学随访相关的中风幸存者特征包括：社会活动受限（与无社会活动受限相比，有社会活动受限的 HR 为 0.64，95%CI 为 0.41-1.01）、自我护理活动受限程度更大（HR 为 1.13，95%CI 为 1.03-1.23）和可能存在痴呆症（与无痴呆症相比，HR 为 2.23，95%CI 为 1.42-3.49）。
大多数中风幸存者随着时间的推移仍会定期进行医学随访。保留中风幸存者定期进行医学随访的策略应针对那些没有社会活动受限、自我护理活动受限程度更大以及可能存在痴呆症的中风幸存者。
