Incidence and Profile of Inpatient Stroke-Induced Aphasia in Ontario, Canada
Incidence and Profile of Inpatient Stroke-Induced Aphasia in Ontario, Canada
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DOI：
10.1016/j.apmr.2009.09.020
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发表时间：
2010-02-01
影响因子：
4.3
通讯作者：
Black, Sandra
中科院分区：
文献类型：
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作者：
Dickey, Laura;Kagan, Aura;Black, Sandra
L，Kagan A.Lindsay MP，Fang J，Rowland A，Black S.加拿大安大略省住院中风失语症的发病率和概况。Arch Phys Med Rehabil 2010：91：196-202.目的：确定加拿大安大略省因中风引起的失语症住院患者的发病率，并分析有和没有失语症的中风患者的人口学和临床特征。设计：使用安大略省中风审计计算安大略省特定年龄和性别的失语症发病率。此外，从加拿大中风网络登记处(RCSN)收集的数据被用来确定患有和不患有失语症的中风患者的人口学和临床特征。背景：加拿大安大略省的所有医院和地区中风中心。参与者：安大略省中风审计是2004/2005财年安大略省所有医院急诊科收治的3000多名中风患者的代表性加权样本。RCSN数据包括2003-2007年在安大略省12个区域卒中中心连续出现的超过15,000名卒中患者的队列。干预措施：不适用。主要观察指标：入院和出院时是否存在失语症状、年龄和性别、卒中类型和严重程度、残疾严重程度、在医院接受的服务、住院时间和出院目的地。结果：2004-2005年安大略省卒中审计期间入院诊断为卒中的成年患者中有35%(1131/3207)在出院时有失语症状。这相当于每年的发病率为每10万人中有60人。失语症的风险随着年龄的增长而显著增加。与非失语性中风患者相比，失语症患者年龄更大，入院时中风更严重，残疾更严重，更频繁地出院接受长期护理和/或康复(未调整结果)。校正了卒中严重程度、年龄、性别、共病和卒中亚型后，失语症的出现被发现是住院时间更长、康复服务使用量增加和溶栓治疗率更高的独立预测因素。结论：中风患者中有相当数量的人经历失语症，年龄越高风险越高。有失语症的中风患者的概况和模式与那些没有失语症作为中风后残留残疾的患者有显著不同，特别是在服务使用方面。考虑到与失语症相关的个人和系统成本，卒中领域的最佳实践应该包括如何在整个临床路径中最好地为这一人群服务的建议。
Dickey L, Kagan A. Lindsay MP, Fang J, Rowland A, Black S. Incidence and profile of inpatient stroke-induced aphasia in Ontario, Canada. Arch Phys Med Rehabil 2010:91:196-202.Objectives: To determine the incidence rate of inpatient stroke-induced aphasia in Ontario, Canada, and to examine the demographic and clinical characteristics for stroke patients with and without aphasia.Design: Age- and sex-specific incidence rates for aphasia in Ontario were calculated using the Ontario Stroke Audit. In addition, data collected from the Registry of the Canadian Stroke Network (RCSN) were used to determine the demographic and clinical characteristics for stroke patients with and without aphasia.Setting: All hospitals and regional stroke centers in Ontario, Canada.Participants: The Ontario Stroke Audit is a representative weighted sample of more than 3000 stroke inpatients admitted to emergency departments in all hospitals in Ontario within the 2004/2005 fiscal year. RCSN data included a cohort of more than 15,000 consecutive patients presenting with stroke at 12 regional stroke centers in Ontario from 2003 to 2007.Interventions: Not applicable.Main Outcome Measures: Presence of aphasic symptoms on admission to hospital and at discharge, age and sex, stroke type and severity, severity of disability, services received in hospital, length of stay, and discharge destination.Results: Thirty-five percent (1131/3207) of adult patients admitted with a diagnosis of stroke in the province of Ontario during the 2004 to 2005 Ontario Stroke Audit had symptoms of aphasia at the time of discharge. This amounts to an incidence rate of 60 per 100,000 persons per year. Risk of aphasia increased significantly with age. In comparison with nonaphasic stroke patients, patients with aphasia were older, presented with more severe strokes on admission, had more severe disability, and were more frequently discharged to long-term care and/or rehabilitation (unadjusted results). Adjusting for stroke severity, age, sex, comorbidity, and stroke subtype, the presence of aphasia was found to be an independent predictor of longer hospital stays, increased use of rehabilitation services, and higher rates of thrombolytic therapy.Conclusions: A significant number of people with stroke experience aphasia, with advancing age associated with a higher risk. The profile and patterns for stroke patients with aphasia differed significantly from those who did not experience aphasia as a residual disability after stroke, particularly in relation to service usage. Given the personal and system cost associated with aphasia, best practices in the area of stroke should include recommendations on how to best serve this population throughout the clinical pathway.