老年缺血性脑卒中患者死亡危险因素的研究

A study of mortality and influential risk factors of ischemic stroke in the elderly patients

目的探讨老年缺血性脑卒中患者住院死亡的危险因素。方法回顾性收集2004年1月—2008年12月确诊的老年急性缺血性脑卒中患者490例,全面采集入院临床特征、既往史及常规实验室检查结果等资料,并将所有病例按照类肝素药物治疗急性缺血性脑卒中试验(TOAST)亚型分类标准进行卒中分型,以住院30 d内死亡为结局,对影响死亡的因素进行单因素和多因素Logistic回归分析。结果病死23例,病死率4.69%。经单因素及多因素Logistic回归分析显示:年龄(OR=1.259,95%CI 1.046～1.516)、并发症(OR=65.073,95%CI 11.505～368.053)及入院NIHSS评分(OR=1.239,95%CI 1.114～1.378)与老年缺血性脑卒中住院死亡独立相关。结论高龄、有并发症、入院NIHSS评分高是老年缺血性脑卒中住院死亡的独立危险因素。

Objective To investigate the independent influential risk factors of ischemic stroke cases in hospital mortality through retrospective analysis of clinical data from the elderly stroke cases. Metheds There were 490 consecutive elderly isehemic stroke cases which were hospitalized in our hospital were retrospectively collected from January 2004 to December 2008. A clinical material about admission character, history of past illness, result of routine laboratory examination were collected and analyzed. The cases were classified into different types according to the TOAST criterion, and death within 30 days was the end index. The influential risk factors on fatality were analyzed by univariate and multivariate logistic regression. Results There were 23 cases （4.69%） died in hospitalized. The results of univariate and multivariate Logistic regression showed that the poor outcome was associated with older age （ OR = 1. 259,95% CI 1. 046- 1. 516 ） , complications （ OR = 65. 073,95% CI 11. 505 - 368. 053 ） , admission NIHSS total scores （ OR = 1. 239,95% CI 1.114 - 1. 378）. Conclusion It suggested that older age, with complications, admission NIHSS total scores were independent risk factors of poor outcome of ischemic stroke.