Functional outcomes by age after inpatient stroke rehabilitation in Saudi Arabia
Functional outcomes by age after inpatient stroke rehabilitation in Saudi Arabia
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DOI：
10.2147/cia.s145402
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发表时间：
2017-01-01
影响因子：
3.6
通讯作者：
Alhaidary, Hisham
中科院分区：
文献类型：
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作者：
Bindawas, Saad M.;Vennu, Vishal;Alhaidary, Hisham
背景：在各种危险因素中，年龄已被确定为中风的不可改变的危险因素，在发达国家和沙特阿拉伯（SA），它影响住院中风康复后的功能结果。随着人口老龄化和中风发病率的增加，对住院中风康复服务的需求也随之增加；然而，这些服务在南澳州有限。 目的：按年龄检查南澳州住院中风康复后的功能结果。 患者和方法：从电子病历中收集了 2008 年 11 月至 2014 年 12 月期间在南澳利雅得法赫德国王医学城康复医院接受住院中风康复治疗的 418 名中风患者的数据。根据患者年龄，我们将参与者分为两组：65 岁成人（n=255）和年龄>= 65 岁的老年人（n=163）。使用功能独立测量（FIM）量表评估所有患者入院和出院时的功能状态。结果：平均年龄为 59.9 岁（SD = 9.4）。与成年人相比，老年人从入院到出院的总 FIM (23 [SD = 15.9]) 和运动 FIM (21 [SD = 15.4]) 的功能结果变化均显着较小，而且他们的独立性 (36%) 明显较差。在调整后的模型中，老年人的分数显着低于成年人，FIM 总分低 11 分 (p < 0.0001)，运动 FIM 子量表分数低 10 分 (p, 0.0001)。认知 FIM 子量表评分没有随年龄发生显着变化。结论：住院卒中康复后，老年人的功能结果有限或独立性低于成年人。然而，这一发现的临床相关性值得怀疑，因此目前没有理由仅仅因为高龄而拒绝患者接受强化中风康复治疗。未来需要进行大规模研究，通过纳入社会支持、社会经济学、合并症和患者康复后意见等混杂因素来确认康复结果。
Background: Among various risk factors, age has been identified as a nonmodifiable risk factor for stroke that influences functional outcomes after inpatient stroke rehabilitation in the developed world as well as in Saudi Arabia (SA). The demand for inpatient stroke rehabilitation services increases with population aging and stroke incidence; however, these services are limited in SA.Objective: To examine functional outcomes by age after inpatient stroke rehabilitation in SA.Patients and methods: Data from 418 patients with stroke who underwent inpatient stroke rehabilitation at the King Fahad Medical City-Rehabilitation Hospital, Riyadh, SA, between November 2008 and December 2014 were collected from electronic medical records. According to the patients' age, we classified participants into two groups: adults, aged,65 years (n=255), and older adults, aged >= 65 years (n=163). All patients' functional statuses at admission and discharge from inpatient stroke rehabilitation were assessed using the functional independence measure (FIM) scale.Results: The mean age was 59.9 years (SD = 9.4). Older adults had significantly smaller changes in functional outcome from admission to discharge on both the total FIM (23 [SD = 15.9]) and the motor FIM (21 [SD = 15.4]), and they were significantly less independent (36%) compared to adults. In the adjusted models, older adults had significantly lower scores than adults, by 11 points (p < 0.0001) for the total FIM score and by 10 points (p, 0.0001) for the motor FIM subscale score. There was no significant change with age in the cognitive FIM subscale score.Conclusion: After inpatient stroke rehabilitation, older adults had limited functional outcomes or were less independent than adults. However, the clinical relevance of this finding is questionable, so there is currently no justification to deny patients access to intensive stroke rehabilitation solely because of advanced age. Future large-scale research is needed to confirm rehabilitation outcomes by including confounders such as social support, socioeconomics, comorbidities, and the patient's opinion after rehabilitation.