ตัวแปรพยากรณ์ผลลัพธ์ระยะยาวด้านความสามารถของผู้ป่วยโรคหลอดเลือดสมองในระยะเฉียบพลัน

ตัวแปรพยากรณ์ผลลัพธ์ระยะยาวด้านความสามารถของผู้ป่วยโรคหลอดเลือดสมองในระยะเฉียบพลัน

Authors

  • รัชวรรณ สุขเสถียร Department of Rehabilitation Medicine, Maharat Nakhon Ratchasima, Meaung, Nakhon Ratchasima, 30000
  • ธันยพร สุขพงษ์ไทย Department of Rehabilitation Medicine, Maharat Nakhon Ratchasima, Meaung, Nakhon Ratchasima, 30000

Keywords:

activities of daily living, functional outcome, long-term outcome, predictor, stroke

Abstract

Objective: To evaluate long-term functional outcomes and predictive variables for good and poor functional outcomes in acute stroke patients.

Study design: A retrospective study.

Setting: Stroke ward and units, Maharat Nakhon Ratchasima Hospital.

Subjects: Stroke patients with acute stroke between January 1 and December 31, 2015.

Method: We recorded patients’ characteristic data: age, sex, premorbid status, diagnosis, comorbidities and complications, neurological examination, management, rehabilitation consultation, length of stay and functional level on admission using Barthel index (BI) score from electronic medical records. Long-term functional outcomes were evaluated with BI score at least 6 months after stroke onset by telephone interview and reviewing medical records. The predictors of long-term functional outcomes were determined with stepwise multiple logistic regression analysis.

Results: Nine hundred and seven patients were included in the present study. Of the 907 patients, 191 (21%) died during acute stroke admission, 117 (13%) died after and 210 (23%) were lost to follow-up and could not be contacted. There were 4 variables that were significantly correlated with good functional outcomes after multiple logistic regression analysis. Subjects aged < 55, Muscle power of the affected side grade > 2, normal consciousness and male gender had adjusted odds ratios of 11.46, 5.88, 5.15 and 3.88 respectively. Five variables that were correlated with poor functional outcomes were: muscle power grade 0-1, aged over 65, impaired consciousness, more than 3 comorbidities and admission BI score below 50. These resulted in adjusted odds ratios of 4.96, 4.85, 2.79, 2.33 and 2.13 respectively.

Conclusion: Long-term functional outcomes of stroke patients were associated with age, muscle power of the affected side, level of consciousness, gender, number of comorbidities and admission BI score.

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Published

2018-09-13