目的 分析院内症状性卒中患者的临床特点，探索院内卒中患者预后不良可能的危险因素。 方法 本研究为前瞻性病例对照研究，纳入2023年1月至9月在中国医学科学院阜外医院住院期间发生卒中患者，收集患者的一般临床特征、实验室检查、住院期间手术方式及卒中发病时美国国立卫生院卒中量表（NIHSS）评分。院内卒中后3个月时对患者进行随访，采用改良版Rankin量表评估患者神经功能预后，0~1分为预后良好，≥2分为预后不良。 结果 共纳入院内症状性卒中患者114例，年龄（61.88±12.41）岁，其中女36例（31.58%，36/114），既往合并卒中10例（8.77%，10/114），心房颤动（房颤）17例（14.91%，17/114）。相关性分析显示，发病时NIHSS评分与入院时尿素氮（r=0.27，P=0.004）及D二聚体（r=0.30，P=0.001）呈显著正相关。院内卒中后3个月随访，预后良好68例（59.65%，68/114），预后不良46例（40.35%，46/114）。房颤病史（OR=4.974，95%CI 1.147~21.562）、发病时中度（OR=11.195，95%CI 3.679~34.072）、重度（OR=25.043，95%CI 2.744~228.572）NIHSS评分是预后不良可能的独立危险因素。 结论 院内症状性卒中患者临床预后风险高，房颤病史、发病时NIHSS评分可能是预后不良的独立危险因素。 Objective To explore clinical characteristics and potential risk factors for poor prognosis in patients with symptomatic in-hospital stroke. Methods This is a prospective case control study. In-hospital stroke patients in Fuwai Hospital from January 2023 to September 2023 were enrolled. The clinical characteristics, laboratory tests, surgical information during hospitalization, and National Institute of Health Stroke Scale (NIHSS) score at the time of stroke onset were collected. Patients were followed up at 3-month after in-hospital stroke and the modified Rankin scale was used to evaluate the neurological function. The score of 0-1 indicated good outcome, whereas≥2 indicated the poor outcome. Results One hundred and fourteen patients with symptomatic stroke were included. The average age was (61.88±12.41) years. Among them, 36 (31.58%, 36/114) were female. Ten (8.77%, 10/114) patients were with prior stroke and 17 (14.91%, 17/114) patients were with history of atrial fibrillation (AF). The NIHSS score at onset was significantly positively correlated with urea nitrogen (r=0.27, P=0.004) and D-dimer (r=0.30, P=0.001) at admission. At 3-month after in-hospital stroke, 68 (59.65%, 68/114) patients had good functional outcome, whereas 46 (40.35%, 46/114) patients had poor outcome. The history of AF (OR=4.974, 95% CI 1.147-21.562), moderate (OR=11.195, 95% CI 3.679-34.072), and severe (OR=25.043, 95% CI 2.744-228.572) severity of stroke assessed by NIHSS maybe the independent risk factors for poor outcome. Conclusion Patients with symptomatic in-hospital stroke had a higher risk for poor outcome, and history of AF and the NIHSS score may be independent risk factors for poor outcome.
Abstract
Objective To explore clinical characteristics and potential risk factors for poor prognosis in patients with symptomatic in-hospital stroke. Methods This is a prospective case control study. In-hospital stroke patients in Fuwai Hospital from January 2023 to September 2023 were enrolled. The clinical characteristics, laboratory tests, surgical information during hospitalization, and National Institute of Health Stroke Scale (NIHSS) score at the time of stroke onset were collected. Patients were followed up at 3-month after in-hospital stroke and the modified Rankin scale was used to evaluate the neurological function. The score of 0-1 indicated good outcome, whereas≥2 indicated the poor outcome. Results One hundred and fourteen patients with symptomatic stroke were included. The average age was (61.88±12.41) years. Among them, 36 (31.58%, 36/114) were female. Ten (8.77%, 10/114) patients were with prior stroke and 17 (14.91%, 17/114) patients were with history of atrial fibrillation (AF). The NIHSS score at onset was significantly positively correlated with urea nitrogen (r=0.27, P=0.004) and D-dimer (r=0.30, P=0.001) at admission. At 3-month after in-hospital stroke, 68 (59.65%, 68/114) patients had good functional outcome, whereas 46 (40.35%, 46/114) patients had poor outcome. The history of AF (OR=4.974, 95% CI 1.147-21.562), moderate (OR=11.195, 95% CI 3.679-34.072), and severe (OR=25.043, 95% CI 2.744-228.572) severity of stroke assessed by NIHSS maybe the independent risk factors for poor outcome. Conclusion Patients with symptomatic in-hospital stroke had a higher risk for poor outcome, and history of AF and the NIHSS score may be independent risk factors for poor outcome.
关键词
卒中/心房颤动/美国国立卫生院卒中量表/预后不良
Key words
Stroke/Atrial fibrillation/National Institute of Health Stroke Scale/Poor outcome
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