Sprafka J M, Virnig B A, Shahar E, McGovern P G
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454-1015.
Diabet Med. 1994 Aug-Sep;11(7):678-84. doi: 10.1111/j.1464-5491.1994.tb00332.x.
This study documented trends in the prevalence of diabetes among men and women hospitalized for acute stroke and determined the effect of diabetes on short- and long-term survival following stroke. These issues were investigated in the Minnesota Heart Survey, a population-based surveillance system that has monitored trends in stroke morbidity and mortality in the Minneapolis-St Paul metropolitan area since 1970. Clinical data were obtained from the hospital records of 50% samples of residents ages 30 to 74 years who were discharged with a diagnosis of acute stroke in 1970, 1980, and 1985. Between 1970 and 1985, the prevalence of diabetes as listed on the discharge diagnoses among stroke patients increased significantly in men (22.4% vs 10.5%; p = 0.006) and non-significantly in women (24.7% vs 15.9%; p = 0.3). During this time period, both in-hospital and 28-day case fatality rates declined in non-diabetic stroke patients but remained unchanged in stroke patients with diabetes. After controlling for the effects of age, sex, survey year, and level of consciousness, diabetes status had little effect on short-term (28-day) mortality of stroke patients, but the odds of 5-year mortality among those surviving to 1 year was 2.0 (95% Cl (1.3, 3.2)) times higher in diabetic compared to non-diabetic individuals. These findings suggest that the prevalence of diabetes has been increasing among stroke patients, and that the diabetic condition is a significant predictor of poorer long-term but not short-term survival following stroke.
本研究记录了因急性中风住院的男性和女性糖尿病患病率的趋势，并确定了糖尿病对中风后短期和长期生存的影响。这些问题在明尼苏达心脏调查中进行了研究，该调查是一个基于人群的监测系统，自1970年以来一直在监测明尼阿波利斯 - 圣保罗大都市地区中风发病率和死亡率的趋势。临床数据来自1970年、1980年和1985年出院诊断为急性中风的30至74岁居民50%样本的医院记录。1970年至1985年间，中风患者出院诊断中列出的糖尿病患病率在男性中显著增加（22.4%对10.5%；p = 0.006），在女性中无显著增加（24.7%对15.9%；p = 0.3）。在此期间，非糖尿病中风患者的住院死亡率和28天病死率均下降，但糖尿病中风患者的死亡率保持不变。在控制了年龄、性别、调查年份和意识水平的影响后，糖尿病状态对中风患者的短期（28天）死亡率影响不大，但与非糖尿病个体相比，存活1年的糖尿病患者5年死亡几率高2.0（95% Cl（1.3, 3.2））倍。这些发现表明，中风患者中糖尿病的患病率一直在增加，并且糖尿病状况是中风后长期而非短期生存较差的重要预测因素。
