| 老年急性脑卒中患者院内死亡的危险因素研究 |
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| 引用本文： | 范虹,吴承龙.老年急性脑卒中患者院内死亡的危险因素研究[J].中华全科医学,2016,14(6):965-967. |
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| 作者姓名： | 范虹 吴承龙 |
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| 作者单位： | 绍兴市人民医院康复科，浙江 绍兴 312000 |
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| 摘 要： | 目的 探讨老年急性脑卒中患者院内死亡的危险因素，以积极防治脑卒中各种并发症的发生。 方法 回顾性分析1 200例老年急性脑卒中患者的病历资料，根据患者病情结局分为死亡组和生存组。多元Logistic回归分析院内死亡的危险因素。 结果 1 200例患者中，死亡75例，病死率为6.25%。死亡组患者年龄(75.9±8.8)岁，显著高于生存组的(64.2±6.7)岁；死亡组出血性卒中的患者显著多于生存组，死亡组既往病史患有糖尿病、脑卒中、冠心病的患者显著多于生存组；死亡组患者NIHSS评分为(15.8±7.4)分，显著高于生存组的(9.5±5.6)分，差异有统计学意义(t=9.223，P＜0.05)；死亡组患者Glasgow评分(9.3±3.1)显著低于生存组(12.6±4.9)，差异有统计学意义(t=5.755，P＜0.05)；死亡组进行中心静脉置管、导尿管、鼻胃管等侵入性操作的患者显著多于生存组，死亡组发生肺部感染、高热、尿路感染、脑心综合征、消化道出血以及下肢静脉血栓的患者显著多于生存组，多元Logistic回归分析结果显示，Glasgow评分低、合并肺部感染、合并脑心综合征及上消化道出血及既往糖尿病史为老年急性脑卒中患者院内死亡的独立危险因素。 结论 老年急性脑卒中患者死亡的危险因素较多，Glasgow评分低、合并肺部感染、脑心综合征、上消化道出血及既往糖尿病史是其独立危险因素，对此类患者应重点监护。
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| 关 键 词： | 急性脑卒中 院内死亡 危险因素 老年 |
| 收稿时间： | 2016-01-13 |
The risk factors of hospital mortality in patients with acute stroke in the elderly |
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| Affiliation: | Department of Rehabilitation,the People’s Hospital of Shaoxing,Shaoxing,Zhejiang 312000,China |
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| Abstract: | Objective Investigate the risk factors of hospital mortality in patients with acute stroke in the elderly.And take active method to prevent acute stroke complications. Methods 1 200 cases of elderly patients with acute stroke were retrospectively analyzed.They were divided into death group and survival group according to the outcome.Multivariate Logistic regression was used to analyze the risk factors for in-hospital mortality. Results There were 75 cases died among 1 200 cases.The mortality rate was 6.25%.The ages in death group were 75.9±8.8,significantly higher than that in survival group 64.2±6.7.The cases that were hemorrhagic stroke in death group were significantly higher than that in survival group.The cases that had history of diabetes,stroke,and coronary heart disease in death group were significantly higher than that in survival group.NIHSS scores in death group were 15.8±7.4,significantly higher than that in survival group 9.5±5.6.The difference had statistical significance(t=9.223,P＜0.05).Glasgow scores in death group were 9.3±3.1,significantly lower than that in survival group 12.6±4.9.The difference had statistical significance(t=5.755,P＜0.05).The cases who received central venous catheter,catheter,and nasogastric tube in death group were significantly higher than that in survival group.High fever,pulmonary infection,urinary tract infection,cerebrocardiac syndrome,gastrointestinal bleeding and venous thrombosis of lower extremity occurred in in death group was significantly higher than that in survival group.Multivariate Logistic regression analysis showed that low Glasgow Coma Score,pulmonary infection,combined with brain heart syndrome and upper digestive tract bleeding and history of diabetes were independent risk factors of death in hospital. Conclusion There are many risk factors of death in patients with acute cerebral stroke in elderly.Low Glasgow Coma Score,pulmonary infection,brain heart syndrome and upper digestive tract bleeding and history of diabetes were independent risk factors of death.We should pay more attention to these patients. |
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