急性脑梗死患者入院临床特征与出院结局的关系

Relationship between admission clinical characteristics and outcome at discharge among acute cerebral infarction patients

目的探讨急性脑梗死患者入院时的临床特征与出院临床结局的关系。方法以2 673例住院急性脑梗死患者为研究对象,收集人口学、生活方式、疾病史、心血管病家族史、入院血压、实验室检验结果以及出院神经功能评分(NIHSS)和死亡资料,研究结局定义为出院NIHSS≥10或住院期间死亡。采用非条件Logistic回归方法,对患者的入院临床特征与研究结局的关系进行分析。结果单因素Logistic回归分析显示,入院时具有高血糖、心房纤颤史和风湿性心脏病病史与研究结局相关联,其OR值分别为2.797、3.807、3.376倍(均有P<0.05)。经多因素调整后,入院时高血糖和心房纤颤史对研究结局的危险性仍然有统计学意义,其OR值分别为2.903和3.370(均有P<0.05)。结论高血糖和心房纤颤史与出院急性脑梗死患者NIHSS≥10或住院期间死亡有关。

Objective To explore the association between admission clinical characteristics and outcome at discharge among acute cerebral infarction patients.Methods A total of 2 673 acute cerebral infarction patients were included in the present study.Data on demographic characteristics,life style risk factors,history of cardiovascular disease,admission blood pressure,laboratory tests,NIHSS at discharge and death in-hospital were collected for all participants,study outcome was defined as NIHSS ≥10 or death at discharge.The association between admission clinical characteristics and study outcome were analyzed by using non-conditional Logistic regression method.Results The results of univariate Logistic regression showed that admission hyperglycemia,history of atrial fibrillation and history of rheumatic heart disease were associated with study outcome,Odds ratio of study outcome associated with admission hyperglycemia,history of atrial fibrillation and history of rheumatic heart disease were 2.797,3.807 and 3.376,respectively,P0.05.After adjusting for multivariate,Odds ratio of study outcome for admission hyperglycemia（2.903） and history of atrial fibrillation（3.370） were still significant,P0.05.Conclusions Hyperglycemia and history of atrial fibrillation were significantly associated with NIHSS ≥10 or death at discharge among acute cerebral infarction patients.