脑卒中患者出院时的功能结局预测

背景通过入院时资料早期预测其出院时的功能结局对于了解预后、计划出院后的转归很有意义,目前关于脑卒中患者平衡功能的研究越来越受到重视,而国内缺乏关于平衡功能与出院时的功能结局的关系报道.目的根据收集的资料预测脑卒中患者出院时的功能结局,以及它与Fugl-Meyer平衡得分、Berg平衡量表得分的相关性.设计以患者为研究对象,多因素、多变量研究.单位一所大学医院的康复科.对象2002-08/2003-05同济医院康复科和神经科住院的符合入选标准的首次脑卒中患者40例.方法将收集的脑卒中患者资料与出院时的功能结局进行单因素和多因素分析,收集的资料包括患者的病史、体格检查、入院时Fugl-Meyer平衡量表评分、Berg平衡量表评分、日常生活活动能力及功能独立性评分,出院时评定功能独立性评分作为功能结局.主要观察指标Berg平衡量表,Fugl-Meyer平衡量表与功能独立性评定的简单相关性分析,出院时功能独立性评分影响因子的逐步回归分析.结果简单线性相关分析提示Berg平衡量表,Fugl-Meyer平衡量表得分与入院、出院功能独立性评定得分有较强的相关性(P＜0.001或P＜0.05),逐步回归分析发现入院时功能独立性评定,日常生活活动能力评分,Berg平衡量表评分可以预测脑卒中患者出院时的功能结局.结论出院时功能结局的预测因子为入院时功能独立性评定,日常生活活动能力评分,Berg平衡量表评分,它与Berg平衡量表有较强的相关性.

Prediction of discharge functional outcome of stroke patients

BACKGROUND: To predict the functional outcome basing on hospitalization data as earlier as possible has important significance for evaluating the prognosis and discharged recovery. In recent years, researches on the balance function of stroke patients has drew more and more attentions, but less related reports about the relationship between balance and discharge functional outcome are available.OBJECTIVE: To predict the discharg functional outcomes of stoke patients basing on hospitalization data, as well as the relationship between it and scores for Fugl-Meyer balance(FMB) and Berg balance scale(BBS).DESIGN: Multiple factors and multi-variable study based on patient' s clinical presentation.SETTING: Rehabilitative department in a college hospital.PARTICIPANTS: Between August 2002 and May 2003, 40 patients with stoke for the first time were hospitalized in Rehabilitative and Neurological Department of Tongji Hospital, who accorded with the enrolling standards.METHODS: The available hospitalization data and discharge functional outcomes were subjected to single factor and multiple factor analysis, and collected data includes the history of disease, physical examination, scores for FMB and BBS when hospitalization, scores for daily life ability(ADL)and functional independence measure(FIM) . Functional outcome was presented by the discharge FIM.MAIN OUTCOME MEASURES: Simple correlative analysis of BBS, FMB and FIM, regressive analysis of discharge FIM influencing factors.RESULTS: Simple liner correlative analysis indicted that scores for BBS and FMB was strongly correlated with the scores for FIM at hospitalization and discharge( P ＜ 0. 001 or P ＜ 0.05), regressive analysis revealed that scores for FIM, ADL and BBS at hospitalization could be used for predicting the discharge functional outcomes of stroke patients.CONCLUSION: Predictors for discharge functional outcomes includes scores for FIM, ADL and BBS when hospitalization, which are closely correlated with BBS.