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: 7162975
• 负责人: BRETT M KISSELA
• 金额: $ 15.28万
• 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 2008-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7162975
• 关键词: Accounting; African American; Age; Area; Caring; Chairperson; Cholesterol; Clinical Research; Communities; Complication; Data; Deep Vein Thrombosis; Development; Diabetes Mellitus; Disabled Persons; Epidemiologist; Epidemiology; Future; Glucose; Goals; Health Policy; Health Services Research; Heart Diseases; Hypertension; Incidence; Institutes; Intervention; Kentucky; Life; Link; Logistics; Measures; Medical; Medicine; Mental Depression; Mentors; Methods; Morbidity - disease rate; Neurology; Numbers; Nursing Research; Outcome; Outcome Study; Outcomes Research; Patients; Perceived quality of life; Physicians; Pneumonia; Population; Prevalence; Principal Investigator; Procedures; Qualifying; Quality of life; Rate; Recording of previous events; Recovery; Regression Analysis; Research; Research Personnel; Research Proposals; Risk Factors; SF-36; Score; Serum; Severities; Societies; Specialist; Standards of Weights and Measures; Stroke; Stroke prevention; Symptoms; Testing; Training; United States; Universities; Urinary tract infection; Work; acute stroke; base; career; college; cost; diabetic; disability; experience; falls; functional outcomes; health care service utilization; health related quality of life; improved; indexing; innovation; knowledge base; medical complication; metropolitan; non-diabetic; post stroke; programs; psychologic

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 tIRQOL. 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 Prinicipal Investigator to become an expert in epidemiology and outcomes research and to use clinical research to improve the lives of diabetic patients with stroke.

就个体而言，糖尿病和中风是导致残疾的最常见原因之一，并会严重影响健康 护理利用和费用。糖尿病患者患中风的年龄较轻，而且发生中风的可能性更高 比非糖尿病患者死亡或致残。这些不良的功能结果给社会带来了高昂的成本。 以前的研究，包括我们自己的研究，已经证明糖尿病和血糖升高一致预测 即使在控制了其他重要变量后，中风后的功能结果也很差。 虽然多项研究令人信服地证明糖尿病患者的中风后结局更糟，但 造成这种差异的原因尚不清楚。之前的中风结果研究并未采取中风后医疗 并发症（肺炎、尿路感染等）或心理并发症，如抑郁症 帐户。人们普遍认为，此类并发症会损害中风后的恢复和生活质量，并且 但只有一项研究通过严格的统计证明了这一点。此外，尚不清楚这些并发症的发生率是否 糖尿病患者和非糖尿病患者之间存在差异。在获得此信息之前，我们将无法开发 糖尿病患者中风预防、急性中风治疗和中风后护理的最佳策略。 糖尿病本身对生活质量有重大影响，通常与抑郁症相关， 并且通常有多种合并症。尽管与健康相关的生活质量 (HRQOL) 指标 SF-36已标准化用于糖尿病患者，目前没有数据显示HRQOL如何变化 糖尿病患者中风后。为了确定是否可以改善糖尿病中风患者的 HRQOL，基线 必须收集有关中风后生活质量的数据。 我们假设糖尿病患者会出现过多的中风后并发症，这解释了 卒中后结果和 HRQOL 的差异。在这项研究完成后，我们将确定发病率 每种并发症及其对结果和 tIRQOL 的影响。通过解释中风后结果的差异，我们 将确定未来干预措施可以改善糖尿病中风患者生活质量的领域。 鉴于中风给糖尿病患者带来的巨大负担，需要一位专家来弥合两者之间的差距 神经病学和糖尿病护理是显而易见的。成为流行病学专家是首席研究员的目标 和结果研究，并利用临床研究来改善患有中风的糖尿病患者的生活。

项目成果

Diabetes: impact on stroke risk and poststroke recovery.

糖尿病：对中风风险和中风后恢复的影响。

• DOI: 10.1055/s-2006-933313
• 发表时间: 2006
• 期刊: Seminars in neurology
• 影响因子: 2.7
• 作者: Kissela,Brett;Air,Ellen
• 通讯作者: Air,Ellen

The value of quality of life research in stroke.

卒中生活质量研究的价值。

• DOI: 10.1161/01.str.0000234047.57744.d9
• 发表时间: 2006
• 期刊: Stroke
• 影响因子: 8.3
• 作者: Kissela,Brett

Clinical prediction of functional outcome after ischemic stroke: the surprising importance of periventricular white matter disease and race.

• DOI: 10.1161/strokeaha.108.521906
• 发表时间: 2009-02
• 期刊: Stroke
• 影响因子: 8.3
• 作者: Kissela B;Lindsell CJ;Kleindorfer D;Alwell K;Moomaw CJ;Woo D;Flaherty ML;Air E;Broderick J;Tsevat J
• 通讯作者: Tsevat J

The adverse effect of spasticity on 3-month poststroke outcome using a population-based model.

• DOI: 10.1155/2014/696089
• 发表时间: 2014
• 期刊: Stroke research and treatment
• 影响因子: 1.5
• 作者: Belagaje SR;Lindsell C;Moomaw CJ;Alwell K;Flaherty ML;Woo D;Dunning K;Khatri P;Adeoye O;Kleindorfer D;Broderick J;Kissela B
• 通讯作者: Kissela B

Heart disease and stroke statistics--2011 update: a report from the American Heart Association.

• DOI: 10.1161/cir.0b013e3182009701
• 发表时间: 2011-02-01
• 期刊: Circulation
• 影响因子: 37.8
• 作者: Roger VL;Go AS;Lloyd-Jones DM;Adams RJ;Berry JD;Brown TM;Carnethon MR;Dai S;de Simone G;Ford ES;Fox CS;Fullerton HJ;Gillespie C;Greenlund KJ;Hailpern SM;Heit JA;Ho PM;Howard VJ;Kissela BM;Kittner SJ;Lackland DT;Lichtman JH;Lisabeth LD;Makuc DM;Marcus GM;Marelli A;Matchar DB;McDermott MM;Meigs JB;Moy CS;Mozaffarian D;Mussolino ME;Nichol G;Paynter NP;Rosamond WD;Sorlie PD;Stafford RS;Turan TN;Turner MB;Wong ND;Wylie-Rosett J;American Heart Association Statistics Committee and Stroke Statistics Subcommittee
• 通讯作者: American Heart Association Statistics Committee and Stroke Statistics Subcommittee