多发病与中风严重程度,亚型,病前残疾和早期死亡率的关联:牛津血管研究
Matthew B Downer1, Linxin Li1, Samantha Carter1
1From the Wolfson Centre for the Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, Wolfson Building-John Radcliffe Hospital, University of Oxford, United Kingdom.
Neurology
|June 15, 2023
概括
多病症在中风患者中很常见,与残疾有关,但不会加重中风的严重程度. 将这些患者纳入试验可以提高外部有效性,而不会影响干预的有效性.
科学领域:
- 神经学 神经学
- 临床试验 临床试验
- 公共卫生 公共卫生
背景情况:
- 患有多病症的患者在中风临床试验中代表性不足.
- 排除标准通常会引用患病前的残疾和对结果的担忧.
- 多发病对中风严重程度和死亡率的影响需要澄清.
研究的目的:
- 确定多病症与中风严重程度的独立关联.
- 为了考虑潜在的混因素,如中风亚型和先发性残疾.
- 评估多病症对中风后死亡率的影响.
主要方法:
- 基于人口的发病率研究 (牛津血管研究,2002-2017年).
- 使用查尔森并发症指数 (CCI) 进行多病症评估.
- 采用后勤,线性和考克斯比例危险模型来分析中风严重程度,亚型,病前残疾和死亡率.
主要成果:
- 多病症 (28.1%的2,492名患者) 与病前残疾有很强的相关性 (mRS ≥2).
- 在调整混因子后,没有发现多病症和缺血性中风严重程度增加之间的独立关联.
- 多发症与较低比例的出血性中风和微弱的90天死亡率有关.
结论:
- 多发症在中风患者中很常见,与先发性残疾有关,而不是独立的中风严重程度.
- 在试验中增加多病患者的纳入,提高了外部有效性.
- 排除多病症患者可能不需要维持干预的有效性.
相关概念视频
01:23Atherosclerosis IV: Nursing Management
26
Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...
26
01:18Factors Affecting Illness
4.3K
When a person's physical, emotional, intellectual, social development or spiritual functioning is compromised, this deviation from a healthy normal state is called illness. Illness creates stress that in turn harms individuals. Irritation, anger, denial, hopelessness, and fear are behavioral and emotional changes an individual experiences in the phases of illness. A variety of factors influence a person's health and well-being.
For instance, risk factors are connected to illness,...
For instance, risk factors are connected to illness,...
4.3K