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脑卒中患者结局报告的现状及影响因素分析:横断面问卷调查研究。

Current Status of Outcomes Reported by Patients With Stroke and an Analysis of Influencing Factors: Cross-Sectional Questionnaire Study.

机构信息

Nursing Department, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China.

Department of Medicine, Southeast University, Nanjing, China.

出版信息

JMIR Form Res. 2024 Aug 26;8:e58330. doi: 10.2196/58330.

Abstract

BACKGROUND

Stroke is the leading cause of acquired disability and the second leading cause of death worldwide. Its rate of incidence, disability, mortality, and recurrence is high, and the patients experience various symptoms of discomfort, which not only affect their rehabilitation function but also reduce their ability to perform daily activities and their quality of life. Nowadays, with the improvement of China's medical standards, patients are increasingly attentive to their quality of life and health status. However, diagnostic techniques and effective treatments for patients with stroke are still limited but urgently required.

OBJECTIVE

This study aimed to evaluate the quality of life during hospitalization using a stroke patient-reported outcomes (PROs) scale and additionally to recognize potential factors and risk indicators that may impact recurrent events, facilitating early intervention measures.

METHODS

This is a registry-based, retrospective observational cross-sectional study on patients with stroke. A convenient sampling method was used to select various indicators of patients. The Stroke-PRO scale was then used to assess patients' conditions across physical, psychological, social, and therapeutic domains. Multiple linear regression analysis was applied to identify factors influencing stroke PROs, while correlation analysis was conducted to explore the relationship between these outcomes and blood lipid levels.

RESULTS

The mean Stroke-PRO score in this study was 4.09 (SD 0.29) points. By multiple linear regression analysis, residence, occupation, physical exercise, Barthel index, Braden scale, National Institutes of Health Stroke Scale scores at admission, and stroke type were the risk factors for reported outcomes of patients with stroke (P<.05). Correlation analysis showed that serum triglyceride, total cholesterol, and low-density lipoprotein were negatively correlated with Stroke-PRO scores in patients with stroke (P<.05), while high-density lipoprotein was positively correlated with patients with stroke (P<.05). The 95% CI was -0.31 to -0.03 for triglyceride, 0.17-0.44 for high-density lipoprotein, -0.29 to -0.01 for cholesterol, -0.30 to -0.02 for low-density lipoprotein, and -0.12 to 0.16 for blood glucose.

CONCLUSIONS

Patients with stroke have a low level of health, and their reported outcomes need to be improved. Accordingly, nursing staff should pay attention to the quality of life and blood lipid indexes of patients with stroke, actively assess their actual health status, and take early intervention measures to promote their recovery.

摘要

背景

脑卒中是全球范围内导致残疾的首要原因和导致死亡的第二大原因。其发病率、致残率、死亡率和复发率均较高,患者伴有各种不适症状,不仅影响其康复功能,而且降低其日常生活活动能力和生活质量。如今,随着我国医疗水平的提高,患者对自身生活质量和健康状况愈发重视。但目前对于脑卒中患者的诊断技术和有效治疗手段仍较为局限,亟待进一步提升。

目的

本研究旨在使用脑卒中患者报告结局(PROs)量表评估住院期间的生活质量,并识别可能影响复发事件的潜在因素和风险指标,以便及时采取早期干预措施。

方法

本研究为基于注册的回顾性、横断面观察性研究,纳入脑卒中患者。采用便利抽样法选取患者的各项指标,采用脑卒中 PRO 量表评估患者在生理、心理、社会和治疗等领域的情况。采用多元线性回归分析识别影响脑卒中 PRO 的因素,采用相关性分析探讨这些结局与血脂水平的关系。

结果

本研究中脑卒中 PRO 量表的平均得分为 4.09(SD 0.29)分。多元线性回归分析显示,居住地、职业、体育锻炼、Barthel 指数、Braden 量表、入院时美国国立卫生研究院脑卒中量表评分和脑卒中类型是脑卒中患者报告结局的危险因素(P<.05)。相关性分析显示,脑卒中患者的血清甘油三酯、总胆固醇和低密度脂蛋白与脑卒中 PRO 评分呈负相关(P<.05),而高密度脂蛋白与脑卒中患者呈正相关(P<.05)。甘油三酯的 95%CI 为-0.31 至-0.03,高密度脂蛋白为 0.17-0.44,胆固醇为-0.29 至-0.01,低密度脂蛋白为-0.30 至-0.02,血糖为-0.12 至 0.16。

结论

脑卒中患者的健康水平较低,需要改善其报告结局。因此,护理人员应关注脑卒中患者的生活质量和血脂指标,积极评估其实际健康状况,并采取早期干预措施,促进其康复。

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