Outcome and Quality of Life after Diabetic Stroke

糖尿病中风后的结果和生活质量

• 批准号: 6560309
• 负责人: BRETT M KISSELA
• 金额: $ 15.14万
• 依托单位: UNIVERSITY OF CINCINNATI
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-01-15 至 2007-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6560309
• 关键词: behavioral /social science research tag; clinical research; comorbidity; diabetes mellitus; functional ability; health care service planning; health disparity; human subject; medical complication; medical records; medical rehabilitation related tag; medically underserved population; nervous system disorder epidemiology; outcomes research; patient oriented research; quality of life; rehabilitation; stroke; stroke therapy

DESCRIPTION (provided by applicant): Individually, diabetes and stroke are among the most common causes of disability and result in substantial health care utilization and expense. Diabetic patients suffer stroke at a younger age and are disproportionately more likely to die or become disabled than non-diabetic patients. These poor functional outcomes have high costs for society. Previous studies, including our own, have demonstrated that diabetes and elevated serum glucose consistently predict poor functional outcome following stroke even after controlling for other significant variables. While multiple studies convincingly document that post-stroke outcomes are worse in patients with diabetes, the reasons for this disparity remain unclear. Previous stroke outcome studies have not taken post-stroke medical complications (pneumonia, urinary tract infections, etc.) or psychological complications such as depression into account. It is generally accepted that such complications impair recovery and perceived quality of life after stroke, and yet only one study has proven this with statistical rigor. Furthermore, it is not known if the rates of these complications differ between diabetic and non-diabetic patients. Until this information is available, we will be unable to develop optimal strategies for stroke prevention, acute stroke treatment, and post-stroke care in diabetic patients. Diabetes itself has a significant impact upon perceived quality of life, is commonly associated with depression, and usually has multiple medical co-morbidities. Although health-related quality of life (HRQOL) measures such as the SF-36 have been standardized for patients with diabetes, there are currently no data showing how HRQOL changes after stroke in patients with diabetes. To determine if HRQOL can be improved for diabetic stroke patients, baseline data regarding post-stroke quality of life must be collected. We hypothesize that there will be an excess of post-stroke complications in diabetic patients, explaining the disparity in post-stroke outcomes and HRQOL. At the completion of this study, we will have determined the incidence of each complication and its impact on outcome and HRQOL. By explaining the disparity in post-stroke outcomes, we will have identified areas where future interventions could improve the quality of life for diabetic stroke patients. Given the enormous burden of stroke on patients with diabetes, the need for a specialist that can bridge the gap between neurology and diabetes care is evident. It is the goal of the Principal Investigator to become an expert in epidemiology and outcomes research and to use clinical research to improve the lives of diabetic patients with stroke.

描述（由申请人提供）：就个人而言，糖尿病和中风是残疾的最常见原因之一，并导致大量的医疗保健利用和费用。糖尿病患者在较年轻的年龄遭受中风，并且比非糖尿病患者更有可能死亡或致残。这些不良的功能结果给社会带来了高昂的代价。以前的研究，包括我们自己的研究，已经证明，即使在控制了其他重要变量后，糖尿病和血清葡萄糖升高也能一致预测卒中后不良的功能结局。虽然多项研究令人信服地证明了糖尿病患者的卒中后结局更差，但这种差异的原因仍不清楚。以往的卒中结局研究未将卒中后医学并发症（肺炎、尿路感染等）或心理并发症，如抑郁症。人们普遍认为这些并发症会损害中风后的恢复和感知生活质量，但只有一项研究通过统计学严谨性证明了这一点。此外，尚不清楚这些并发症的发生率在糖尿病患者和非糖尿病患者之间是否存在差异。在这些信息可用之前，我们将无法制定糖尿病患者卒中预防、急性卒中治疗和卒中后护理的最佳策略。糖尿病本身对感知的生活质量有显著影响，通常与抑郁症相关，并且通常具有多种医学共病。虽然健康相关生活质量（HRQOL）指标（如SF-36）已被糖尿病患者标准化，但目前尚无数据显示糖尿病患者卒中后HRQOL如何变化。为了确定是否可以改善糖尿病卒中患者的HRQOL，必须收集有关卒中后生活质量的基线数据。我们假设糖尿病患者卒中后并发症过多，这解释了卒中后结局和HRQOL的差异。在本研究完成时，我们将确定每种并发症的发生率及其对结局和HRQOL的影响。通过解释卒中后结局的差异，我们将确定未来干预措施可以改善糖尿病卒中患者生活质量的领域。鉴于中风对糖尿病患者的巨大负担，显然需要一位专家来弥合神经病学和糖尿病护理之间的差距。主要研究者的目标是成为流行病学和结局研究方面的专家，并利用临床研究改善糖尿病卒中患者的生活。