Stroke severity in atrial fibrillation - The Framingham study
Stroke severity in atrial fibrillation - The Framingham study
复制标题
DOI：
10.1161/01.str.27.10.1760
复制
发表时间：
1996-10-01
期刊：
影响因子：
8.3
通讯作者：
DAgostino, RB
中科院分区：
文献类型：
--
作者：
Lin, HJ;Wolf, PA;DAgostino, RB
背景和目的根据临床系列，房颤（AF）卒中比非房颤卒中更有可能致死性或更严重，但来自前瞻性流行病学研究的数据很少且不一致。方法对5070例Framingham队列患者进行40年的随访，分析了501例首发缺血性卒中患者，其中103例合并房颤。中风严重程度分为无、轻度、中度、严重和致命。自1981年以来，Barthel指数所指示的功能状态已在3、6和12个月时进行了急性评估。采用chi(2)检验和Student’st检验比较AF卒中与非AF卒中的严重程度和功能状态。采用logistic回归分析评估30天死亡率。结果房颤与卒中严重程度增加相关（P= 0.048）。房颤卒中的30天死亡率高于非房颤卒中（25% vs 14%）。房颤患者30天死亡率的多变量校正优势比为1.84（95%可信区间为1.04 ~ 3.27）。自1981年以来，对150例缺血性卒中患者进行了随访，其中包括30例房颤患者。与非房颤组相比，房颤组在1年随访期间生存率较低，复发率较高。AF组患者急性期Barthel指数平均得分较低(29.6比58.6，P
Background and Purpose Stroke occurring with atrial fibrillation (AF) is more likely to be fatal or more severe than non-AF stroke based on clinical series, but data from prospective epidemiological studies are sparse and inconsistent.Methods Over 40-year follow-up of the original 5070 Framingham cohort, 501 initial ischemic strokes, including 103 with AF, were analyzed. Stroke severity was rated as none, mild, moderate, severe, or fatal. Since 1981, functional status indicated by the Barthel index has been evaluated acutely and at 3, 6, and 12 months. Severity and functional status of AF strokes were compared with non-AF strokes using chi(2) test and Student's t test. Thirty-day mortality was assessed by logistic regression analyses.Results AF was associated with increased stroke severity (P=.048). Thirty-day mortality was greater in AF strokes than in non-AF strokes (25% versus 14%). The multivariate-adjusted odds ratio for 30-day mortality for AF subjects was 1.84 (95% confidence interval, 1.04 to 3.27). Since 1981, follow-up was available for 150 initial ischemic strokes, including 30 with AF. Compared with the non-AF group, the AF group had poorer survival and more recurrences during 1 year of follow-up. The AF subjects had lower mean Barthel index scores acutely (29.6 versus 58.6, P