Disability Status and Secondary Prevention Among Survivors of Stroke: A Cross-Sectional Analysis of the 2011 to 2018 National Health and Nutrition Examination Survey.
Disability Status and Secondary Prevention Among Survivors of Stroke: A Cross-Sectional Analysis of the 2011 to 2018 National Health and Nutrition Examination Survey.
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DOI：
10.1161/jaha.123.030869
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发表时间：
2023-12-05
影响因子：
5.4
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中科院分区：
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在卒中幸存者中，坚持二级预防治疗与卒中复发风险降低相关。然而，并不是所有的中风幸存者都使用二级中风预防治疗。我们研究了中风幸存者的残疾状况与他们对糖尿病、高脂血症和高血压的治疗和控制之间的关系。在2011年至2018年全国健康和营养检查调查的横断面分析中，我们比较了自报年龄≥20岁的有残疾和无残疾的卒中幸存者中糖尿病、高脂血症和高血压的治疗和控制率。残疾定义为使用结构化问卷评估的5个身体或4个功能领域中的任何一个的自我报告。Logistic回归模型调整了年龄，性别，种族和民族，以及病史，用于估计残疾状态和危险因素治疗和控制之间的关联。卒中幸存者的平均年龄为65.1岁，55.5%为女性; 76%（95% CI，72.7%-79.3%）自我报告至少有1项残疾。糖尿病、高脂血症和高血压的年龄标准化治疗率分别为33.1%（95% CI，26.9%-39.2%）、67.5%（95% CI，62.6%-72.3%）和78.4%（95% CI，74.6%-82.2%）。糖尿病、高脂血症和高血压的年龄标准化控制率分别为86.8%（95% CI，83.8%-89.8%）、20.5%（95% CI，15.0%-25.9%）和47.1%（95% CI，42.6%-51.7%）。在调整后的模型中，那些有残疾和没有残疾的人有相似的风险因素治疗和控制的几率。在美国，四分之三的中风幸存者自我报告残疾，与无残疾的患者相比，这些患者接受糖尿病、高脂血症和高血压治疗和控制的几率相似。
Among survivors of stroke, adherence to secondary prevention care is associated with decreased risk of recurrent stroke. However, not all survivors of stroke use secondary stroke prevention treatment. We examined the association between the disability status of survivors of stroke and their treatment and control of diabetes, hyperlipidemia, and hypertension. In a cross‐sectional analysis of the 2011 to 2018 National Health and Nutrition Examination Survey, we compared diabetes, hyperlipidemia, and hypertension treatment and control rates among self‐reported survivors of stroke age ≥20 years with and without disability. Disability was defined as self‐reporting any of 5 physical or 4 functional domains assessed using a structured questionnaire. Logistic regression models adjusted for age, sex, race and ethnicity, and history of medical conditions were used to estimate associations between disability status and risk factor treatment and control. The mean age of survivors of stroke was 65.1 years, and 55.5% were female; 76% (95% CI, 72.7%–79.3%) self‐reported at least 1 disability. Age‐standardized treatment rates for diabetes, hyperlipidemia, and hypertension were 33.1% (95% CI, 26.9%–39.2%), 67.5% (95% CI, 62.6%–72.3%), and 78.4% (95% CI, 74.6%–82.2%), respectively. Age‐standardized control rates for diabetes, hyperlipidemia, and hypertension were 86.8% (95% CI, 83.8%–89.8%), 20.5% (95% CI, 15.0%–25.9%), and 47.1% (95% CI, 42.6%–51.7%), respectively. In adjusted models, those with and without disabilities had similar odds of risk factor treatment and control. In the United States, three‐quarters of survivors of stroke self‐reported a disability, and these patients had similar odds of diabetes, hyperlipidemia, and hypertension treatment and control compared with those without disability.