THE ROLE OF PROGNOSTIC SCORES IN TARGETING STROKE REHABILITATION IN ELDERLY PATIENTS
THE ROLE OF PROGNOSTIC SCORES IN TARGETING STROKE REHABILITATION IN ELDERLY PATIENTS
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DOI：
10.1111/j.1532-5415.1993.tb06947.x
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发表时间：
1993-04-01
影响因子：
6.3
通讯作者：
CROME, P
中科院分区：
文献类型：
--
作者：
KALRA, L;CROME, P
设计、地点和对象：对96例75岁以上的老年卒中患者进行为期一年的前瞻性队列研究。测量：分别在卒中后1周、2周和4周测量爱丁堡预后评分(包括运动缺陷、本体感觉和能力的测量)、Orpington预后评分(改良的爱丁堡评分包括认知测量)和Barthel ADL评分。结果：Edinburgh预后评分与出院时或16周Barthel日常生活能力评分显著相关(R2=0.57，P<；0.001)，Orpington预后评分相关性更强(R2=0.89vs0.57)，尤其是痴呆患者(R2=0.81vs0.39)。治疗后2周的Barthel ADL评分与出院时或16周的Barthel ADL评分呈弱相关(R2=0.58)。Orpington评分5.2分的患者需要长期护理。大多数Orpington评分在3-5之间的患者(90%)最终出院，尽管这在入院时的初始临床评估中并不总是明显的。结论：在卒中后2周进行评估时，Orpington评分是一个有用的预后指标，对老年人具有特殊的适用性，可能有助于选择最有可能从卒中单元康复中受益的患者。
Objective: To determine the validity of clinically derived prognostic scores in targeting stroke rehabilitation in elderly patients.Design, Setting and Participants: One-year prospective cohort study in 96 hospitalized stroke patients over 75 years of age from a well defined geographical area.Measurements: Edinburgh prognostic score (incorporating measures of motor deficit, proprioception, and power), Orpington prognostic score (Edinburgh score modified to include a measure of cognition), and Barthel ADL scores were measured at 1, 2, and 4 weeks after stroke. These scores were correlated with outcome and patients' Barthel ADL score at discharge or at 16 weeks if still in hospital.Results: Edinburgh prognostic score measured at 2 weeks correlated significantly with Barthel ADL score at discharge or at 16 weeks (r2 = 0.57, P < 0.001), and Orpington prognostic scores showed greater correlation (r2 = 0.89 vs 0.57), especially in patients with dementia (r2 = 0.81 vs 0.39). Barthel ADL scores at 2 weeks showed a weak correlation with Barthel ADL scores at discharge or 16 weeks (r2 = 0.58). Patients with Orpington Score 5.2 required long-term care. Most patients (90%) with Orpington Score of 3-5 were eventually discharged home although this was not always apparent on initial clinical assessment at the time of admission.Conclusions: The Orpington score when assessed at 2-weeks post-stroke is a useful prognostic indicator with special suitability for the elderly and may help to select patients most likely to benefit from stroke unit rehabilitation.