Anand Karnam, Sirisha Sai, Putta Sanjana, Vooturi Sudhindra, Panigrahi Manas, Jayalakshmi Sita, Kaul Subhash
Department of Neurology, Krishna Institute of Medical Sciences, Secunderabad, Telangana, India.
Department of General Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India.
Ann Indian Acad Neurol. 2024 Nov 1;27(6):647-650. doi: 10.4103/aian.aian_448_24. Epub 2024 Dec 19.
For stroke survivors (SS) who undergo decompressive craniectomy (DC), quality of life is intertwined with the care they receive. Burden on caregiver becomes an important determinant of recovery of SS. In this study, we aimed to analyze the determinants of burden on caregivers of SS who undergo DC.
Caregivers of 198 SS who underwent DC formed the study population of this prospective observational study. The study was conducted in a tertiary referral unit between September 2019 and March 2021. Caregiver burden was quantified using Zarit Burden Interview. Analysis for association between the reported burden and modified Rankin Scale (mRS) score was done.
Mean age of the participants was 47.00 ± 11.2 years. The mRS outcome was poor in SS aged >60 years, Glasgow coma scale (GCS) score at presentation of <8, and in SS with bilateral/dominant hemisphere involvement. Outcome was better when DC was done ≤48 h (74.2% vs. 47.2%, P < 0.001) and if SS were shifted to a rehabilitation unit. Among caregivers, 58% and 16% reported to be always and frequently burdened, respectively; 33.3% of caregivers considered a retrospective review of consent for DC. A higher mRS score was associated with more burden.
Early DC and care at rehabilitation unit were associated with better functional outcomes in SS. Nearly 75% of caregivers of patients post-DC reported high burden of providing care to SS, and the burden increased linearly with mRS score.
对于接受去骨瓣减压术(DC)的中风幸存者(SS)而言,生活质量与他们所接受的护理密切相关。照顾者的负担成为SS康复的一个重要决定因素。在本研究中,我们旨在分析接受DC的SS的照顾者负担的决定因素。
198名接受DC的SS的照顾者构成了这项前瞻性观察性研究的研究人群。该研究于2019年9月至2021年3月在一家三级转诊单位进行。使用Zarit负担访谈对照顾者负担进行量化。对报告的负担与改良Rankin量表(mRS)评分之间的关联进行了分析。
参与者的平均年龄为47.00±11.2岁。年龄>60岁的SS、就诊时格拉斯哥昏迷量表(GCS)评分<8的SS以及双侧/优势半球受累的SS的mRS结局较差。当DC在≤48小时内进行时(74.2%对47.2%,P<0.001)以及如果SS被转移到康复单位,结局更好。在照顾者中,分别有58%和16%报告总是和经常感到负担;33.3%的照顾者考虑对DC同意书进行回顾性审查。较高的mRS评分与更多负担相关。
早期DC和在康复单位的护理与SS更好的功能结局相关。近75%的DC术后患者的照顾者报告为SS提供护理的负担很重,并且负担随mRS评分呈线性增加。