中风后3 - 6个月痉挛的预测因素：一项5年回顾性队列研究。

Predictors of Spasticity 3-6 Mos After Stroke: A 5-Yr Retrospective Cohort Study.

作者信息

McIntyre Amanda, Teasell Robert, Saikaley Marcus, Miller Thomas

机构信息

From the Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada (AM); Lawson Health Research Institute, London, Ontario, Canada (AM); Parkwood Institute Research, Parkwood Institute, London, Ontario, Canada (RT, MS, TM); Physical Medicine and Rehabilitation, St. Joseph's Health Care London, Parkwood Institute, London, Ontario, Canada (RT, TM); and Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada (RT, TM).

出版信息

Am J Phys Med Rehabil. 2024 Dec 1;103(12):1130-1134. doi: 10.1097/PHM.0000000000002496. Epub 2024 Oct 7.

DOI:10.1097/PHM.0000000000002496

PMID:38713591

Abstract

OBJECTIVE

The aim of the study is to identify predictors of poststroke spasticity (modified Ashworth Scale scores, ≥1) at 3-6 mos after stroke.

DESIGN

A 5-yr (2015-2020) retrospective cohort of patients who attended inpatient stroke rehabilitation in Southwestern Ontario, Canada, were included. Sociodemographic, clinical, stroke-related, rehabilitation-related, and outcome measure data were extracted from paper charts and electronic databases.

RESULTS

Of the 922 individuals attending inpatient stroke rehabilitation, 606 (55.8% males; mean age = 70.9 ± 14.2 yrs) returned for an outpatient visit. Most patients had a first ever ( n = 518; 85.5%), ischemic ( n = 470; 77.6%) stroke with hemiplegia ( n = 449, 74.1%). A total of 20.3% ( n = 122) of patients had developed poststroke spasticity by 4 mos after stroke. A binary logistic regression significantly predicted poststroke spasticity (χ 2 (6) = 111.696, P < 0.0001) with good model fit (χ 2 (8) = 12.181, P = 0.143). There were six significant poststroke spasticity predictors: hemorrhagic stroke ( P = 0.049), younger age ( P < 0.001), family history of stroke ( P = 0.015), Functional Independence Measure admission score ( P < 0.001), use of selective serotonin reuptake inhibitors ( P = 0.044), and hemiplegia ( P < 0.001).

CONCLUSIONS

Patients should be monitored closely for poststroke spasticity after discharge from stroke rehabilitation and throughout the care continuum.

摘要

目的

本研究旨在确定卒中后3 - 6个月时卒中后痉挛（改良Ashworth量表评分≥1）的预测因素。

设计

纳入了加拿大安大略省西南部接受住院卒中康复治疗患者的一项为期5年（2015 - 2020年）的回顾性队列研究。从纸质病历和电子数据库中提取社会人口统计学、临床、卒中相关、康复相关及结局测量数据。

结果

在922名接受住院卒中康复治疗的患者中，606人（55.8%为男性；平均年龄 = 70.9±14.2岁）返回门诊就诊。大多数患者为首次（n = 518；85.5%）、缺血性（n = 470；77.6%）卒中伴偏瘫（n = 449，74.1%）。共有20.3%（n = 122）的患者在卒中后4个月时出现了卒中后痉挛。二元逻辑回归显著预测了卒中后痉挛（χ2(6)=111.696，P<0.0001），模型拟合良好（χ2(8)=12.181，P = 0.143）。有六个显著的卒中后痉挛预测因素：出血性卒中（P = 0.049）、较年轻的年龄（P<0.001）、卒中家族史（P = 0.015）、功能独立性测量入院评分（P<0.001）、使用选择性5-羟色胺再摄取抑制剂（P = 0.044）和偏瘫（P<0.001）。