Cho Andrew, Lakhani Dhairya A, Balar Aneri B, Salim Hamza, Koneru Manisha, Hillis Argye, Gonzalez Fernández Marlis, Vagal Vaibhav, Urrutia Victor, Faizy Tobias D, Heit Jeremy J, Albers Greg W, Mazumdar Ishan, Chen Kevin, Sepehri Sadra, Kim Minsoo, Luna Licia, Mei Janet, Yedavalli Vivek S, Hyson Nathan
Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD 21218, USA.
Department of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26505, USA.
J Clin Med. 2024 Nov 25;13(23):7119. doi: 10.3390/jcm13237119.
The relative level of functional impairment in stroke patients is a significant determinant of post-acute care. The Activity Measure for Post Acute Care 6-Clicks (AM-PAC) scores for basic mobility and daily activity are rapid standardized assessments whose utilities in predicting long-term stroke outcomes have not yet been studied. We performed a retrospective analysis of acute ischemic stroke patients and their outcomes. We evaluated the distribution of outcomes using the chi-square test. We then compared the proportions of patients with good stroke outcomes for different combinations of favorable scores. We performed two-proportion z-tests to determine the significance, and < 0.05 was considered significant. 282 patients met all of the inclusion criteria between 12 January 2017 and 19 March 2023 ( age = 66.4, 59.9% female). After dichotomizing the scores as "favorable" vs. "unfavorable", we found that 128/155 (82.6%) patients with favorable basic mobility had good stroke outcomes vs. 20/127 (15.7%) with unfavorable basic mobility ( < 0.0001). Similarly, for favorable daily activity, it was 103/113 (91.2%) vs. 45/169 (26.6%), for both favorable, it was 100/109 (91.7%) vs. 48/173 (27.7%), and for neither favorable, it was 17/123 (13.8%) vs. 131/159 (82.4%), all with < 0.0001. When comparing among groups, both favorable patients differed significantly from those with favorable basic mobility alone ( = 0.033) but not those with favorable daily activity alone ( = 0.875). Even after adjusting for age, the odds ratios of favorable scores were greater than 20 for any combination ( < 0.001). Basic mobility and daily activity AM-PAC scores at discharge are independent predictors of anterior circulation acute ischemic stroke outcomes at 90 days.
中风患者功能障碍的相对程度是急性后期护理的一个重要决定因素。急性后期护理6点击活动量表（AM-PAC）的基本活动能力和日常活动得分是快速标准化评估，其在预测中风长期预后方面的效用尚未得到研究。我们对急性缺血性中风患者及其预后进行了回顾性分析。我们使用卡方检验评估预后的分布情况。然后，我们比较了不同有利得分组合的中风预后良好患者的比例。我们进行了双比例z检验以确定显著性，P<0.05被认为具有显著性。在2017年1月12日至2023年3月19日期间，282名患者符合所有纳入标准（年龄=66.4岁，59.9%为女性）。将得分分为“有利”和“不利”后，我们发现，基本活动能力有利的患者中有128/155（82.6%）中风预后良好，而基本活动能力不利的患者中为20/127（15.7%）（P<0.0001）。同样，日常活动有利的患者中，这一比例为103/113（91.2%）对45/169（26.6%）；两者都有利的患者中，为100/109（91.7%）对48/173（27.7%）；两者都不利的患者中，为17/123（13.8%）对131/159（82.4%），所有这些比较的P均<0.0001。在组间比较时，两项均有利的患者与仅基本活动能力有利的患者有显著差异（P=0.033），但与仅日常活动有利的患者无显著差异（P=0.875）。即使在调整年龄后，任何组合的有利得分的比值比均大于20（P<0.001）。出院时的基本活动能力和日常活动AM-PAC得分是前循环急性缺血性中风90天预后的独立预测因素。
