EARLY PREDICTORS OF DEATH AND DISABILITY AFTER ACUTE CEREBRAL ISCHEMIC EVENT
EARLY PREDICTORS OF DEATH AND DISABILITY AFTER ACUTE CEREBRAL ISCHEMIC EVENT
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DOI：
10.1161/01.str.26.3.392
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发表时间：
1995-03-01
期刊：
影响因子：
8.3
通讯作者：
PRUVO, JP
中科院分区：
文献类型：
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作者：
HENON, H;GODEFROY, O;PRUVO, JP
背景和目的 目前正在进行许多临床试验来评估神经保护剂和溶栓剂改善缺血性中风后生存和功能结果的能力。出于伦理和方法学原因，此类试验需要生存和残疾的早期预测因子。本研究的目的是确定哪些变量（在中风发病后前 24 小时内易于评估的变量）可以作为 8 天死亡率和 3 个月临床结果的预测因子。 方法 对 152 名连续发生急性缺血事件的患者在症状出现后 24 小时内进行评估。我们确定了 (1) 8 天死亡率和 (2) 3 个月功能结果（格拉斯哥结果量表）。通过逐步逻辑回归分析测试了以下潜在的结果预测因素：年龄、性别、体重指数、心房颤动、既往中风、是否存在头痛、Orgogozo 评分、意识水平、吞咽障碍、偏盲、脉率、平均血压、血细胞比容、血糖和计算机断层扫描数据（脑萎缩评分、高密度大脑中叶评分） 结果 多变量分析显示，8 天死亡率仅取决于入院时的意识水平（P=.0001）；第 3 个月的死亡或依赖性（格拉斯哥结果量表评分 3 至 5）取决于临床缺陷的严重程度 (P=.0001)、既往卒中 (P=.0018) 和年龄 (P=.0237)。结论 在未来的药物试验中，“积极治疗”组和“安慰剂”组之间的患者分布应根据临床缺陷的严重程度、卒中病史和年龄进行平衡。 年龄。
Background and Purpose Many clinical trials are currently being conducted to evaluate the ability of neuroprotectors and thrombolytic agents to improve survival and functional outcome after ischemic stroke. Such trials require early predictors of survival and disability for ethical and methodological reasons. The aim of the study was to determine which variables, of those easily assessable during the first 24 hours after stroke onset, would be predictors of 8-day mortality rate and 3-month clinical outcome.Methods One hundred fifty-two consecutive patients with an acute ischemic event were evaluated within 24 hours after symptom onset. We determined (1) the 8-day mortality rate and (2) the 3-month functional outcome (Glasgow Outcome Scale). The following potential predictors of outcome were tested by means of a stepwise logistic regression analysis: age, sex, body mass index, atrial fibrillation, previous stroke, existence of headache, Orgogozo score, level of consciousness, swallowing disturbances, hemianopia, pulse rate, mean blood pressure, hematocrit, glycemia, and computed tomographic scan data (cerebral atrophy score, hyperdense middle cerebral artery sign, number of silent infarcts, leukoaraiosis score).Results The multivariate analysis revealed that the 8-day mortality rate depended only on the level of consciousness at admission (P=.0001); death or dependence at month 3 (scores 3 to 5 on the Glasgow Outcome Scale) depended on the severity of the clinical deficits (P=.0001), previous stroke (P=.0018), and age (P=.0237).Conclusions In future drug trials, the distribution of patients between ''active treatment'' and ''placebo'' groups should be balanced regarding the severity of clinical deficits, history of stroke, and age.