Profile and 1-Year Outcome of Ischemic Stroke in East China: Nanjing First Hospital Stroke Registry
Profile and 1-Year Outcome of Ischemic Stroke in East China: Nanjing First Hospital Stroke Registry
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华东地区缺血性脑卒中概况及一年转归：南京市第一医院脑卒中登记中心
DOI：
10.1016/j.jstrokecerebrovasdis.2015.08.032
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发表时间：
2016-01-01
影响因子：
2.5
通讯作者：
Zhou, Jun-shan
中科院分区：
文献类型：
--
作者：
Shi, Guo-mei;Zhang, Ying-dong;Zhou, Jun-shan
背景：在中国南京，急性缺血性卒中（AIS）后的特征和1年结局尚不确定。本研究旨在调查华东地区AIS患者1年随访后的特征和结局。方法：在一项前瞻性队列研究中，连续招募了2168例AIS患者。主要结局是死亡或依赖，定义为12个月时改良兰金量表评分为3-6分。从现有变量中选择死亡或依赖性的合理风险因素，如人口统计学、心血管疾病风险因素、临床特征、实验室检查结果和卒中后并发症，进行多变量logistic回归分析。结果：837例（38.6%）患者死亡或产生依赖。多因素Logistic回归分析显示，年龄（比值比[OR]，1.04; 95%置信区间[CI]，1.03-1.05），糖尿病史（OR，1.50; 95% CI，1.10-2.04），既往卒中（OR，2.08; 95%CI，1.51-2.87），美国国立卫生研究院卒中量表（NIHSS）评分（OR，23.06; 95%CI，14.24-37.34），估计肾小球滤过率（OR，1.65; 95%CI，1.02-2.66），肺部感染（OR，2.98; 95% CI，2.17-4.09），和胃肠道出血（OR，7.81; 95%CI，2.76-22.09）与较高的死亡率或残疾率显著独立相关（所有P值<0.05）。男性（P值<0.001）是与较低的死亡率或残疾相关的唯一因素。结论：死亡或依赖性的主要主要预测因素是年龄较大、女性、糖尿病、既往卒中、NIHSS评分、估计肾小球滤过率、肺部感染和胃肠道出血。
Background: The profile and 1-year outcome after acute ischemic stroke (AIS) in Nanjing, China, is uncertain. This study aimed to investigate the profile and outcome after 1-year follow-up of AIS in East China. Methods: In a prospective cohort study, 2168 patients with AIS were recruited consecutively. The primary outcome was death or dependency defined as a modified Rankin Scale score of 3-6 at 12 months. Plausible risk factors of death or dependency, such as demographics, risk factors of cardiovascular diseases, clinical features, laboratory results, and complications after a stroke, were selected from available variables to perform multivariable logistic regression analyses. Results: Eight hundred thirty-seven (38.6%) patients died or suffered from dependency. Multivariate logistic regression analysis showed that age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.03-1.05), history of diabetes mellitus (OR, 1.50; 95% CI, 1.10-2.04), prior stroke (OR, 2.08; 95% CI, 1.51-2.87), National Institutes of Health Stroke Scale (NIHSS) score (OR, 23.06; 95% CI, 14.24-37.34), estimated glomerular filtration rate (OR, 1.65; 95% CI, 1.02-2.66), pulmonary infection (OR, 2.98; 95% CI, 2.17-4.09), and gastrointestinal bleeding (OR, 7.81; 95% CI, 2.76-22.09) were significantly and independently associated with higher rates of mortality or disability (all P values < .05). Male gender (P values < .001) was the only factor associated with lower mortality or disability. Conclusions: The main dominating predictors for death or dependency were older age, female gender, diabetes mellitus, prior stroke, NIHSS score, estimated glomerular filtration rate, pulmonary infection, and gastrointestinal bleeding.