The American Heart Association stroke outcome classification: Executive summary
The American Heart Association stroke outcome classification: Executive summary
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DOI：
10.1161/01.cir.97.24.2474
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发表时间：
1998-06-23
期刊：
影响因子：
37.8
通讯作者：
Trombly, CA
中科院分区：
文献类型：
--
作者：
Kelly-Hayes, M;Robertson, JT;Trombly, CA
中风仍然是当今美国的主要公共卫生问题之一，每年约有50万新发或复发病例。1今天大约有400万人在中风中幸存下来，并有一些神经缺陷。虽然用于治疗和康复中风幸存者的医疗资源的规模是相当大的，到目前为止，还没有开发出一个标准化的，全面的分类系统，以记录由此产生的损伤和残疾。任何致残性疾病（包括中风）的成功管理都应受益于使用分类系统来判断治疗的影响，特别是新兴疗法。卒中转归研讨会2的方法学问题的参与者确定，卒中恢复的复杂性要求澄清其自然史和功能恢复的可变模式的分类。为了使卒中幸存者得到最好的护理，需要一个全面的卒中结局分类系统来指导适当的治疗干预。3基于卒中结局专题讨论会的工作和建议，美国心脏协会卒中结局分类工作组致力于开发一个有效可靠的全球分类系统，准确总结卒中后发生的神经损伤、残疾和障碍。卒中结局分类系统的开发基于神经功能缺损通常导致永久性损伤、残疾和生活质量受损的信念。4-6虽然一个人完成日常功能任务的能力被认为在很大程度上取决于并往往受到损害的类型和程度的限制，但其他因素往往与功能结果的最终确定有关。7-9因此，卒中结局的分类应包括广泛的残疾和损伤，以及残疾和损伤与独立功能的关系。重要的是要强调，损伤本身并不能确定残疾程度。在一项对中风幸存者的研究中10，确定了尽管残疾最直接地受到损伤的影响，但是测量损伤的当前中风量表仅部分地解释了存活至少6个月的患者的残疾水平、障碍或生活质量。有些人能很好地适应中风引起的许多和/或严重的损伤。其他只有轻微神经损伤的人可能会严重残疾。许多因素决定功能，包括中风后康复训练的影响以及物理和社会环境。
Stroke remains one of the major public health problems in the United States today, with approximately 500 000 new or recurrent cases occurring each year. 1 About 4 000 000 persons alive today have survived a stroke and have some neurological deficits. Although the magnitude of healthcare resources used to treat and rehabilitate stroke survivors is considerable, to date a standardized, comprehensive classification system to document the resultant impairments and disability has not been developed. Successful management of any disabling disease, including stroke, should benefit from the use of a classification system to judge the impact of treatment, particularly emerging therapies. Participants in the Methodologic Issues in Stroke Outcome Symposium2 determined that the complex nature of stroke recovery demands clarification of its natural history and classification of the variable patterns of functional recovery. For stroke survivors to receive the best care, a comprehensive stroke outcome classification system is needed to direct appropriate therapeutic interventions. 3 Building on the work and recommendations of the Stroke Outcome Symposium, the American Heart Association Classification of Stroke Outcome Task Force has worked to develop a valid and reliable global classification system that accurately summarizes the neurological impairments, disabilities, and handicaps that occur after stroke. The development of a stroke outcome classification system is predicated on the belief that neurological deficits often lead to permanent impairments, disabilities, and compromised quality of life. 4–6 Although a person’s ability to complete daily functional tasks is thought to be largely dependent on and often limited by the type and degree of impairment, additional factors are often relevant in the ultimate determination of functional outcome. 7–9 Thus, a classification of stroke outcome should include the broad range of disabilities and impairments as well as the relationship of disability and impairment to independent function.It is important to underscore that impairment alone does not define level of disability. In a study of stroke survivors10 it was determined that although a disability is most directly influenced by impairments, current stroke scales that measure impairments only partially explained the level of disability, handicap, or quality of life for those surviving at least 6 months. Some persons adapt well to many and/or severe impairments caused by stroke. Others with only minimal neurological impairments can be severely disabled. Many factors determine function, including the influence of poststroke rehabilitation training and the physical and social environments.