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急性缺血性卒中血管内治疗后第1周卒中损伤评估集与吞咽困难及早期出院回家的相关性:一项回顾性观察研究

Association of Stroke Impairment Assessment Set and Dysphagia in the 1st Week after Acute Ischemic Stroke with Early Discharge to Home Following Endovascular Therapy: A Retrospective Observational Study.

作者信息

Harayama Eisei, Tanaka Shota, Yamauchi Kota, Arakawa Shuji

机构信息

Department of Rehabilitation, Social Medical Corporation Steel Memorial Yawata Hospital, Japan.

Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Japan.

出版信息

Phys Ther Res. 2025;28(1):14-21. doi: 10.1298/ptr.E10313. Epub 2024 Dec 24.

Abstract

OBJECTIVE

In this study, we aimed to identify factors associated with the likelihood of early discharge to home by the 7th-day assessment in patients with ischemic stroke who underwent endovascular therapy (EVT).

METHODS

Among the 128 patients with ischemic stroke who underwent EVT, 2 groups were identified: an early discharge to the home group and the transfer group, with patients included in the latter group needing to be transferred to rehabilitation hospitals. Variables from the 7th day were used as explanatory variables to determine the outcome. Multiple logistic regression analysis was conducted using these variables. Receiver operating characteristic (ROC) curves for the significant factors were obtained, and cutoff values were calculated.

RESULTS

There were 19 patients (14.8%) in the early discharge to the home group and 109 patients (85.2%) in the transfer group. The Stroke Impairment Assessment Set (SIAS) (odds ratio [OR]: 1.16, 95% confidence interval [CI]: 1.02-1.32, p = 0.03) and the presence of dysphagia (OR: 8.75, 95% CI: 1.55-49.45, p = 0.01) were significant factors associated with early discharge home. The area under the ROC curve of the SIAS was 0.90, with a cutoff value of 63.5 points.

CONCLUSION

Our results suggest that SIAS scores and the presence of dysphagia within the 1st week post-onset are significant predictors of whether patients with ischemic stroke who undergo EVT can be early discharged home.

摘要

目的

在本研究中,我们旨在确定接受血管内治疗(EVT)的缺血性中风患者在第7天评估时与早期出院回家可能性相关的因素。

方法

在128例接受EVT的缺血性中风患者中,确定了2组:早期出院回家组和转院组,后一组的患者需要转至康复医院。将第7天的变量用作解释变量以确定结果。使用这些变量进行多因素逻辑回归分析。获得显著因素的受试者工作特征(ROC)曲线,并计算临界值。

结果

早期出院回家组有19例患者(14.8%),转院组有109例患者(85.2%)。中风损伤评估量表(SIAS)(比值比[OR]:1.16,95%置信区间[CI]:1.02 - 1.32,p = 0.03)和吞咽困难的存在(OR:8.75,95% CI:1.55 - 49.45,p = 0.01)是与早期出院回家相关的显著因素。SIAS的ROC曲线下面积为0.90,临界值为63.5分。

结论

我们的结果表明,发病后第1周内的SIAS评分和吞咽困难的存在是接受EVT的缺血性中风患者能否早期出院回家的重要预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f59/12047045/b94ba3239d8d/ptr-28-14-g001.jpg

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