缺血性卒中的临床特征及3个月死亡预测因素

发布时间：2018-08-09 19:37

【摘要】：目的:探讨缺血性卒中的临床特征及其3个月死亡的预测因素。方法:基于南京医科大学附属南京医院卒中登记数据库,前瞻性登记2004—2008年间缺血性卒中患者,详细记录其人口学资料、临床特征、实验室检查结果等数据。卒中发病后90 d采用电话或问卷调查形式随访患者本人或家属,记录所有预后、临床事件及其发生时间,临床事件包括死亡、卒中复发、其他并发症等。采用改良的Rankin量表(m RS)对患者预后进行评分。对可能影响死亡的危险因素进行单因素和多因素分析。结果:本研究共纳入1 835例缺血性卒中患者,3个月随访时死亡233例,病死率为12.7%。多因素分析结果显示:年龄(OR1.019,95%CI 1.004~1.034)、房颤史(OR 1.944,95%CI 1.219~3.098)、中重度神经功能缺损(OR 6.253,95%CI 4.315~9.061)、肺部感染(OR 4.109,95%CI 2.841~5.944)、消化道出血(OR 4.245,95%CI 2.086~8.639)是缺血性卒中死亡的独立危险因素(P0.05)。结论:年龄、房颤史、中重度神经功能缺损、肺部感染、消化道出血是卒中后3个月死亡的独立危险因素。
[Abstract]:Objective: to investigate the clinical features of ischemic stroke and the prognostic factors of 3-month death. Methods: based on the stroke registration database of Nanjing Hospital affiliated to Nanjing Medical University, patients with ischemic stroke from 2004 to 2008 were prospectively registered. The demographic data, clinical characteristics and laboratory results were recorded in detail. The patients were followed up by telephone or questionnaire 90 days after stroke to record all prognosis, clinical events and their occurrence time, clinical events including death, stroke recurrence, other complications and so on. A modified Rankin scale (m RS) was used to evaluate the prognosis of the patients. Univariate and multivariate analysis of possible risk factors for death was carried out. Results: a total of 1 835 patients with ischemic stroke were included in this study. 233 patients died after 3 months follow-up. The mortality was 12. 7%. Multivariate analysis showed that age (OR 1.01995 CI 1.0041.034), history of atrial fibrillation (OR 1.94495 CI 1.2193.098), moderate and severe neurological impairment (OR 6.253 卤95CI 4.3159.061), pulmonary infection (OR 4.10995CI 2.841t5.944) and gastrointestinal hemorrhage (OR 4.24595 CI 2.0868.639) were independent risk factors of ischemic stroke death (P0.05). Conclusion: age, history of atrial fibrillation, moderate and severe neurological impairment, pulmonary infection and gastrointestinal hemorrhage are independent risk factors for death 3 months after stroke.
【作者单位】：南京医科大学附属南京医院药学部;南京医科大学附属南京医院神经内科;南京医科大学附属南京医院门诊办公室;中国药科大学药学院;
【基金】：南京医科大学科技发展基金面上项目(2013NJMU072);南京医科大学科技发展基金重点项目(2010NJMUZ038) 南京市卫生局杰出青年基金(JQX12008)
【分类号】：R743.3

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