应用SOAR评分预测急性脑卒中患者住院期间的死亡风险

发布时间：2018-03-30 02:14

  本文选题：急性脑卒中　切入点：不良预后　出处：《大连医科大学》2013年硕士论文

【摘要】：背景和目的：急性脑卒中的预后评分(或模型)有很多的作用。但真正实现在临床上使用前,必须认真评价此类预后评分(模型)的可靠性、真实性及在临床上的应用价值。近2年发表的SOAR评分系统用来预测急性卒中预后的方法已在国外某些研究机构中被证实有很好的预测能力,但至今还未在临床上广泛推广和应用。采用两所三级甲等医院神经内科的急性脑卒中患者的临床数据,对SOAR评分系统在临床中的可靠性、可行性进行一些列研究,目的在于了解该评分系统在的实际应用价值。研究方法：对2013年10月-2015年2月在大连市友谊医院、大连市第三人民医院神经内科住院的脑梗死、脑出血住院患者进行前瞻性登记。对登记的215例患者进行前瞻性收集,并记录SOAR评分所包含的4个变量,包括卒中类型(Stroke type)、牛津郡社区卒中分类(OCSP)、年龄(Age)和卒中前残疾水平评分(mRS)预测急性卒中患者发病后第7天及出院时的死亡风险,应用样本数据分别以卒中后第7天、出院时的功能残障评分(mRS评分≥3)和死亡定义为不良结局事件；通过logistic回归模型判断SOAR评分对卒中后预后风险的预测价值；利用秩相关判断该模型总分值与不良预后相关程度。研究结果：卒中后第7天和出院时的出现不良结局(mRs≥3分)的患者分别为47例(21.8%)和56例(26.4%),死亡23例(10.6%)。根据logistic模型可以验证：SOAR评分能够预测急性脑卒中患者发病7天及发病及出院时的死亡风险；根据秩和分析相关系数,可以肯定SOAR量表各变量相加总分数与卒中后第7天、出院时的不良结局(死亡风险)高度相关,其相关系数分别为0.670、0.676。
[Abstract]:Background and objective: prognostic scores (or models) play a significant role in acute stroke. However, the reliability of such prognostic scores (models) must be carefully evaluated before they can be used in clinical practice. The methods used to predict the prognosis of acute stroke by SOAR scoring system published in recent two years have been proved to have good predictive ability in some foreign research institutions. But it has not been widely popularized and applied in clinic up to now. Using the clinical data of patients with acute cerebral apoplexy in neurology department of two Grade 3A hospitals, the reliability and feasibility of SOAR scoring system in clinic were studied. Objective to understand the practical application value of the scoring system. Methods: to study the cerebral infarction in Department of Neurology, Dalian third people's Hospital, Dalian Friendship Hospital from October 2013 to February 2015. Patients with intracerebral hemorrhage (ICH) were prospectively registered. The four variables included in the SOAR score were recorded. The stroke type Stroke type, Oxfordshire Community Stroke Classification (OCSP), and pre-stroke disability level score (mRSs) were used to predict the risk of death in patients with acute stroke on the 7th day after onset and at discharge. Sample data were used to measure the risk of death on the 7th day after stroke. Functional disability score (Mrs 鈮，

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