摘要
目的 探讨老年缺血性脑卒中后遗症住院患者的衰弱状况及危险因素.方法 回顾性分析2021年12月至2023年12月湖南省益阳市中心医院老年医学科、康复医学科、中西医结合科收治的缺血性脑卒中后遗症老年住院患者295例,根据Fried量表评估分为衰弱组150例及非衰弱组145例,收集临床资料并进行老年综合评估,分析缺血性脑卒中后遗症住院患者衰弱的影响因素.结果 在295例缺血性脑卒中后遗症患者中,衰弱患病率为50.8％(150/295).在衰弱组中,高龄(>75岁)、入院时美国国立卫生研究院卒中量表(NIHSS)评分>8分、低学历、营养不良、抑郁状态、认知功能障碍、睡眠障碍、摄入多药(≥3种)、高跌倒风险的比例明显高于非衰弱组(P<0.05).衰弱组患者血红蛋白(HB)水平低于非衰弱组,衰弱组患者血清肌酐(CRE)水平高于非衰弱组(P<0.05).二元logistic回归分析表明,上述因素是患者发生衰弱的独立危险因素(P<0.05).结论 老年缺血性脑卒中后遗症患者的衰弱现象较为普遍,且受多种危险因素影响,在临床中应从多角度对衰弱患者予以干预.
Abstract
Objective To investigate the debilitating status and risk factors of elderly inpatients with sequelae of ischemic stroke. Methods A total of 295 elderly inpatients with sequelae of ischemic stroke admitted to the Department of Geriatric Medicine,the Department of Rehabilitation Medicine and the Department of Integrated Traditional Chinese and Western Medicine in Yiyang Central Hospita from December 2021 to December 2023 were retrospectively analyzed. According to the Fried scale,they were divided into the debilitating group (n=150) and the non-debilitating group (n=145). The clinical data were collected and comprehensively evaluated for the elderly,and the influencing factors of debilitating inpatients with sequelae of ischemic stroke were analyzed. Results Among 295 patients with sequelae of ischemic stroke,the prevalence of debilitating was 50.8％ (150/295). In the debilitating group,the proportion of old age (>75 years old),National Institute of Health stroke scale (NIHSS) score>8 points at admission,low education level,malnutrition,depression,cognitive dysfunction,sleep disorder,consuming multiple medications ( ≥ 3 types),and high risk of falling was significantly higher than that in the non-debilitating group (P<0.05). The level of hemoglobin (HB) in the debilitating group was lower than that in the non-debilitating group,while the level of serum creatinine (CRE) in the debilitating group was higher than that in the non-debilitating group (P<0.05). Binary logistic regression analysis showed that the above factors were independent risk factors for patients' debilitating (P<0.05). Conclusion Debilitating phenomenon in elderly patients with sequelae of ischemic stroke is relatively common,and it is influenced by various risk factors,intervention should be given to debilitating patients from multiple perspectives in clinic.
维普
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