Li Ning, Zhang Jia, Du Yang, Li Jing, Wang Anxin, Zhao Xingquan
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Beijing, China.
Ann Clin Transl Neurol. 2024 Dec;11(12):3163-3174. doi: 10.1002/acn3.52222. Epub 2024 Oct 11.
The association between gait speed and adverse outcomes after stroke has not been fully illustrated. This study aimed to explore the association of gait speed on long-term outcomes in minor stroke or transient ischemic attack (TIA).
We performed a longitudinal study with acute minor stroke or TIA based on a subgroup of the Third China National Stroke Registry data. The gait speed was evaluated using a 10-meter walking test at discharge and 3 months after the stroke onset. The primary outcomes were poor functional outcomes at 1 year, defined by a modified Rankin Score (mRS) of 2-6. Additional outcomes included all-cause death, ambulate dependency (mRS score 4-6), cognitive impairment (Montreal Cognitive Assessment <26), stroke recurrence, and composite vascular events.
The study sample included a total of 1542 stroke patients with a median age of 60 (53-68). At 1-year follow-up, 140 (9.20%) patients experienced poor functional outcomes. Faster gait speed at discharge was associated with lower incidence of poor functional outcome (OR = 0.89; 95% CI, 0.84-0.94), cognitive impairment (OR = 0.93; 95% CI, 0.89-0.96), ischemic stroke recurrence (HR = 0.92; 95% CI, 0.87-0.98), and composite vascular events (HR =0.94; 95% CI, 0.89-0.99) at 1 year. Faster gait speed at 3 months was associated with lower incidence of poor functional outcome (OR = 0.90; 95% CI, 0.85-0.95), ambulate dependency (OR = 0.86; 95% CI, 0.77-0.97), and cognitive impairment (OR = 0.92; 95% CI, 0.88-0.95) at 1 year.
Our findings indicated that slow gait speed after minor stroke or TIA may be an independent predictor for long-term poor outcomes. Gait speed may be considered as a vital sign during follow-up in post-stroke patients.
卒中后步速与不良结局之间的关联尚未得到充分阐明。本研究旨在探讨步速与轻度卒中或短暂性脑缺血发作（TIA）长期结局之间的关联。
我们基于第三次中国国家卒中登记数据的一个亚组，对急性轻度卒中和TIA患者进行了一项纵向研究。在出院时及卒中发作后3个月，采用10米步行试验评估步速。主要结局为1年时功能结局不佳，定义为改良Rankin量表（mRS）评分为2 - 6分。其他结局包括全因死亡、行走依赖（mRS评分4 - 6分）、认知障碍（蒙特利尔认知评估<26分）、卒中复发和复合血管事件。
研究样本共纳入1542例卒中患者，中位年龄为60岁（53 - 68岁）。在1年随访时，140例（9.20%）患者出现功能结局不佳。出院时步速较快与1年时功能结局不佳（OR = 0.89；95%CI，0.84 - 0.94）、认知障碍（OR = 0.93；95%CI，0.89 - 0.96）、缺血性卒中复发（HR = 0.92；95%CI，0.87 - 0.98）及复合血管事件（HR = 0.94；95%CI，0.89 - 0.99）的发生率较低相关。卒中发作后3个月步速较快与1年时功能结局不佳（OR = 0.90；95%CI，0.85 - 0.95）、行走依赖（OR = 0.86；95%CI，0.77 - 0.97）及认知障碍（OR = 0.92；95%CI，0.88 - 0.95）的发生率较低相关。
我们的研究结果表明，轻度卒中和TIA后步速缓慢可能是长期不良结局的独立预测因素。步速可被视为卒中后患者随访期间的一项生命体征。
