OUTCOME AND TIME-COURSE OF RECOVERY IN STROKE .1. OUTCOME - THE COPENHAGEN STROKE STUDY
OUTCOME AND TIME-COURSE OF RECOVERY IN STROKE .1. OUTCOME - THE COPENHAGEN STROKE STUDY
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DOI：
10.1016/s0003-9993(95)80567-2
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发表时间：
1995-05-01
影响因子：
4.3
通讯作者：
OLSEN, TS
中科院分区：
文献类型：
--
作者：
JORGENSEN, HS;NAKAYAMA, H;OLSEN, TS
目的：评价根据初始卒中严重程度和初始残疾程度分层的卒中结局。设计：前瞻性，连续性和社区为基础。背景：丹麦一家医院的卒中科。该机构接收来自哥本哈根市内239，886名居民的明确集水区的所有急性中风患者。急性治疗以及康复的所有阶段都在卒中单元内进行，无论年龄、卒中严重程度和病前状况如何。患者：1197例急性卒中患者。主要结局指标：主要结局指标为死亡、出院至疗养院或回家。使用斯堪的纳维亚神经卒中量表和Barthel指数，在完成康复后和卒中发作后6个月再次测量次要结局为神经功能缺损和功能障碍。结果：223例（19%）患者的卒中最初非常严重，171例（14%）为重度，316例（26%）为中度，487例（41%）为轻度。250例（21%）患者在住院期间死亡，177例（15%）患者出院至疗养院，770例（64%）患者出院回家。完成康复治疗后，11%的幸存者仍有重度或极重度神经功能缺损，11%有中度缺损，78%无或仅有轻度缺损; 20%重度或极重度残疾，8%中度残疾，26%轻度残疾，46%日常生活活动无残疾。还提供了根据初始卒中严重程度/残疾分层的结局的详细信息。结论：这项研究提供了一个全面的描述中风康复的需要在社区和中风幸存者的康复后残疾的数量。对于结局预测，结果可用作一种可靠的工具，用于在卒中急性期使用简单、可靠的评分来说明以卒中严重程度和/或功能障碍的初始程度为特征的患者中发生各种结局的机会（或风险）。然而，这些结果不应作为选择急性期康复患者的指南，因为即使是最严重的病例在康复期间也会经常出现有意义的改善。(C)1995年由美国康复医学大会和美国物理医学与康复学会
Objective: To evaluate the outcome of stroke stratified according to both initial stroke severity and initial level of disability. Design: Prospective, consecutive, and community based. Setting: A stroke unit of a hospital in Denmark. This setting receives all acute stroke patients admitted from a well-defined catchment area of 239,886 inhabitants within the City of Copenhagen. Acute treatment as well as all stages of rehabilitation are cared for within the stroke unit regardless of age, stroke severity, and premorbid condition. Patients: 1197 patients with acute stroke. Main Outcome Measures: Primary outcome was measured as death, discharge to nursing home, or to own home. Secondary outcome was measured as neurological deficits and functional disabilities after completed rehabilitation and again 6 months after stroke onset, using the Scandinavian Neurological Stroke Scale and the Barthel Index. Results: Stroke was initially very severe in 223 (19%) of the patients, severe in 171 (14%), moderate in 316 (26%), and mild in 487 (41%) patients. Two hundred and fifty (21%) patients died during hospital stay, 177 (15%) were discharged to nursing home, and 770 (64%) patients were discharged to their own home. After completed rehabilitation, 11% of survivors still had severe or very severe neurological deficits, 11% had moderate deficits, and 78% had no or only mild deficits; 20% were severely or very severely disabled, 8% were moderately disabled, 26% were mildly disabled, and 46% had no disability in activities of daily living. Detailed information on outcome stratified according to initial stroke severity/disability also is presented. Conclusions: This study provides a thorough description of the needs for stroke rehabilitation in the community and the amount of postrehabilitation disability in stroke survivors. For outcome prediction, the results can be used as a reliable tool for prognostication of the chances (or risks) of various outcomes in patients characterized by initial degree of stroke severity and/or functional disability using simple, reliable scores in the acute phase of stroke. However, the results should not be used as a guideline for selecting patients for rehabilitation in the acute phase because even the most severe cases regularly experience meaningful improvement during rehabilitation. (C) 1995 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation