脑卒中后日常生活活动受限：来自埃塞俄比亚一家三级医院的经验。

Post-stroke limitations in daily activities: experience from a tertiary care hospital in Ethiopia.

机构信息

Internal Medicine Department, Neurology Unit, School of Medicine, College of Health Sciences, Wollo University, Dese, Ethiopia.

School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

出版信息

BMC Neurol. 2023 Oct 9;23(1):364. doi: 10.1186/s12883-023-03419-9.

DOI:10.1186/s12883-023-03419-9

PMID:37814255

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10561502/

Abstract

BACKGROUND

The disability of stroke patients remains an important global health problem; yet information on the extent of restriction from basic and instrumental activities of daily living is limited, particularly in lower-and middle-income (LMIC) countries. Therefore, we examined the issue under the caption, since it is the first step in planning several rehabilitation services.

METHOD

A facility-based cross-sectional study was done to assess the magnitude and predictors of post-stroke limitations in basic activities of daily living (BADL) using the Barthel Index (BI) scale and instrumental activities of daily living (IADL) using the Frenchay Activities Index (FAI) scale among patients who visited Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, Neurology Clinic from April-October, 2022. All patients having a diagnosis of stroke for more than six months duration were enrolled. Descriptive and inferential statistical analyses were done, and measures of estimated crude and adjusted odds ratio with 95% CI were constructed and a p-value less than 0.05 was considered statistically significant. The results are presented in figures and tables.

RESULTS

A total of 150 stroke patients were enrolled in the present study. The mean age of participants was 53 (14.9) years with slight male preponderance (51.3%). Ischemic stroke was present in 106 (70.7%) of them, while 44 (29.3%) had hemorrhagic stroke. Of this, 57 (38%) and 115 (79.3%) of them had limitations in basic and instrumental ADL, respectively. Comorbid cardiac disease (AOR = 6.9; 95%CI = 1.3-37.5) and regular substance use (AOR = 11.1; 95%CI = 1.1-115) were associated with limitations in BADL, while an increase in age (AOR = 1.1; 95%CI = 1.04-1.15) was associated with severe limitations in BADL. Initial stroke severity (AOR = 7.3; 95%CI = 1.2-44.7) was associated with limitations in IADL, whereas depression (AOR = 5.1; 95%CI = 1.1-23.2) was identified as a predictor of severe limitation in IADL.

CONCLUSION

Limitation in activities of daily living (ADL) after stroke is common among Ethiopian patients. Therefore, screening for post-stroke limitations in daily activities is essential for further management and rehabilitative plans.

摘要

背景

中风患者的残疾仍然是一个重要的全球健康问题；然而，有关日常生活基本活动和工具性活动受限程度的信息有限，特别是在中低收入国家。因此，我们在标题下研究了这个问题，因为这是规划多项康复服务的第一步。

方法

这是一项基于机构的横断面研究，旨在使用巴氏指数（BI）量表评估基本日常生活活动（BADL）受限程度，并使用法国活动指数（FAI）量表评估工具性日常生活活动（IADL）受限程度，对象为 2022 年 4 月至 10 月在埃塞俄比亚亚的斯亚贝巴提克努尔安贝萨专科医院神经病学诊所就诊的中风患者。所有患者的中风诊断时间均超过 6 个月。进行描述性和推断性统计分析，并构建了估计的粗和调整后的比值比及其 95%置信区间的测量值，p 值小于 0.05 被认为具有统计学意义。结果以数字和表格形式呈现。

结果

本研究共纳入 150 例中风患者。参与者的平均年龄为 53（14.9）岁，男性略占优势（51.3%）。其中 106 例（70.7%）为缺血性中风，44 例（29.3%）为出血性中风。其中，57 例（38%）和 115 例（79.3%）分别在基本和工具性 ADL 中受限。合并心脏疾病（OR=6.9；95%CI=1.3-37.5）和常规物质使用（OR=11.1；95%CI=1.1-115）与 BADL 受限相关，而年龄增加（OR=1.1；95%CI=1.04-1.15）与严重 BADL 受限相关。初始中风严重程度（OR=7.3；95%CI=1.2-44.7）与 IADL 受限相关，而抑郁（OR=5.1；95%CI=1.1-23.2）是 IADL 严重受限的预测因素。