Health status of individuals with mild stroke
Health status of individuals with mild stroke
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DOI：
10.1161/01.str.28.4.740
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发表时间：
1997-04-01
期刊：
影响因子：
8.3
通讯作者：
Matchar, D
中科院分区：
文献类型：
--
作者：
Duncan, PW;Samsa, GP;Matchar, D
背景和目的卒中患者的生活质量下降和较高水平的身体功能受限往往被低估，并且不能被Barthel指数和Rankin结果量表等指标完全反映出来。这项研究使用其他措施来评估304名轻度中风患者的健康状况，并将这些人与184名短暂性脑缺血发作患者和654名没有中风/短暂性脑缺血发作病史但中风风险较高的人(无症状组)进行比较。方法受试者来自学术医学中心联盟(住院患者)、心血管健康研究(65岁及以上社区居民的人口样本)和联合医疗保健(住院患者和门诊患者通常小于65岁)。通过电话或面谈的方式对受试者进行日常生活活动(Barthel指数)、抑郁(流行病学研究中心抑郁量表)、健康状况(MOS-36)和对当前健康状况的效用的评估。卒中组在MOS-36上的损害比无症状组更严重，但与短暂性脑缺血发作组相似。中风患者与健康相关的生活质量最低。症状状态和Barthel指数评分对健康状况的预测作用最强，Barthel指数与MOS-36的躯体功能分量表相比，表现出一致的天花板效应。结论即使是轻度中风，其后果也影响除疼痛外的所有健康维度。对中风患者的标准化评估必须在整个健康相关功能的连续体中进行评估。
Background and Purpose Diminished quality of life and limitations in higher levels of physical functioning are often underestimated in stroke and are not fully captured by measures such as the Barthel Index and the Rankin Outcome Scale. This study used additional measures to assess the health status of 304 persons with mild stroke and to compare these individuals with 184 persons with transient ischemic attack and 654 persons without history of stroke/transient ischemic attack but at elevated risk for stroke (asymptomatic group).Methods Subjects were recruited from the Academic Medical Center Consortium (inpatients), the Cardiovascular Health Study (population-based sample of community-dwelling persons 65 years and older), and United HealthCare (inpatients and outpatients typically younger than 65 years). Subjects were interviewed by telephone or in person to assess activities of daily living (Barthel Index), depression (Center for Epidemiological Studies Depression Scale), health status (MOS-36), and utility for current health state.Results Most respondents were independent an all Barthel items. The stroke group was more impaired on the MOS-36 than the asymptomatic group but similar to the group with transient ischemic attack. Health-related quality of life was lowest for persons with stroke. While symptom status and Barthel Index score were the strongest predictors of health status, the Barthel Index showed a consistent ceiling effect when compared with the physical function subscale of the MOS-36.Conclusions The consequences of even mild stroke affect all dimensions of health except pain. Standardized assessment of persons with stroke must evaluate across the entire continuum of health-related functions.