Impact of functional status at six months on long term survival in patients with ischaemic stroke: prospective cohort studies
Impact of functional status at six months on long term survival in patients with ischaemic stroke: prospective cohort studies
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DOI：
10.1136/bmj.39456.688333.be
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发表时间：
2008-02-16
影响因子：
--
通讯作者：
Sandercock, Peter
中科院分区：
文献类型：
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作者：
Slot, Karsten Bruins;Berge, Eivind;Sandercock, Peter
目的 评估缺血性中风后六个月功能状态对长期生存的影响。设计前瞻性队列研究。设置三个队列：牛津郡社区中风项目、洛锡安中风登记册和第一个国际中风试验（英国）。参与者 1981 年至 2000 年间登记的 7710 名缺血性中风患者，随访最长 19 年。主要结果指标采用改良 Rankin 量表评估中风后 6 个月的功能状态或“两个简单的问题”。随访期间的死亡率。使用 Kaplan-Meier 曲线、对数秩检验和 Cox 回归模型进行生存分析。 结果 在所有三个队列的综合分析中，在中风后 6 个月生存至评估的患者中，日常生活独立者和依赖者的后续中位生存期分别为 9.7 年（95% 置信区间 8.9 至 10.6）和 6.0 年（5.7 至 6.4）。在对牛津郡和洛锡安队列的综合分析中，患者的中位生存期逐渐从 12.9 年（10.0 岁增加到 15.9 年）。对于 Rankin 评分为 5 的患者，中风后 6 个月至 2.5 年（1.4 至 3.5）Rankin 评分为 0-1。所有先前所述的中位生存期差异均显着（对数秩检验 P
Objective To estimate the impact on long term survival of functional status at six months after ischaemic stroke.Design Prospective cohort study.Settings Three cohorts: Oxfordshire community stroke project, Lothian stroke register, and the first international stroke trial (in the United Kingdom).Participants 7710 patients with ischaemic stroke registered between 1981 and 2000 and followed up for a maximum of 19 years.Main outcome measures Functional status at six months after stroke assessed with modified Rankin scale or "two simple questions." Mortality during follow-up. Survival analysis with Kaplan-Meier curves, log rank test, and Cox's regression model.Results In a combined analysis of all three cohorts, among patients who survived to assessment six months after the index stroke, the subsequent median length of survival among those independent in daily living and those dependent was 9.7 years (95% conifidence interval 8.9 to 10.6) and 6.0 years (5.7 to 6.4), respectively. In a combined analysis of the Oxfordshire and Lothian cohorts, subsequent median survival felt progressively from 12.9 years (10.0 to 15.9) for patients with. a Rankin score of 0-1 at six months after the stroke to 2.5 years (1.4 to 3.5) for patients with a Rankin score of 5. All previously stated differences in median survival were significant (log rank test P