急性期疲劳对首发脑梗死老年患者患病结局的影响

Effects of acute fatigue on the outcome of aged patients with initial cerebral infarction

目的 探讨急性期卒中后疲劳对老年脑梗死患者患病结局的影响.方法 应用疲劳严重程度量表调查240例老年脑梗死患者急性期疲劳发生情况,并于患者出院时及出院1年后评估其预后,观察急性期疲劳对患者功能恢复和存亡状况的影响.结果 37. 1%(89/240)患者存在急性期疲劳的感受.多因素 Logistic 回归分析显示,高入院 NIHSS 评分( OR=2. 472,95% CI= 1. 931~3. 164)、急性期PSF(OR=4. 820,95%CI=2. 281~10. 187)是老年脑梗死患者出院时功能恢复的影响因素(P<0. 01).高入院NIHSS评分(OR=1. 674,95% CI=1. 411~1. 985)、急性期PSF( OR=2. 123, 95%CI=1. 187~3. 796)、出院时mRS评分≥2分( OR=9. 822,95%CI=4. 899~19. 693)、复发( OR=6. 146,95%CI=2. 596~14. 553)是影响老年脑梗死患者出院1年后功能恢复的独立危险因素(P<0. 05).多因素 Cox 回归分析显示,年龄( OR=1. 096,95% CI=1. 027~1. 169)、急性期 PSF( OR=5. 233,95%CI=1. 051~6. 053)和复发(OR=13. 983,95%CI=2. 821~49. 307)是老年脑梗死患者死亡的独立预测因子(P<0. 05).结论 急性期卒中后疲劳会影响老年脑梗死患者功能恢复及存亡状况.

Objective To investigate the effects of acute fatigue on the outcome of aged patients with cerebral infarction.Methods The Fatigue Severity Scale was used to investigate the incidence of fa-tigue in 240 elderly patients with acute cerebral infarction,to assess the outcome of the patients at discharge and one year after discharge,and to analyze the effect of acute fatigue on the functional recovery and survival of patients.Results Totally 89 patients(37.1%)suffered from acute fatigue.Multivariate Logistic regres-sion analysis showed that high admission NIHSS score(OR=2.472,95%CI=1.931-3.164)and acute post-stroke fatigue(OR=4.820,95%CI=2.281~10.187)were the influencing factors for functional recovery of elderly patients with cerebral infarction at discharge(P<0.01).High admission NIHSS score(OR=1.674,95%CI=1.411-1.985),acute post-stroke fatigue(OR=2.123,95%CI=1.187-3.796),mRS score≥2 at discharge(OR=9.822,95%CI=4.899-19.693)and recurrence(OR=6.146,95%CI=2.596-14.553)were independent risk factors for functional recovery of elderly patients with cerebral infarction one year after dis-charge(P<0.05).Multivariate Cox regression analysis showed that age(OR=1.096,95%CI=1.027-1.169),post-stroke fatigue in acute phase OR=5.233,95%CI=1.051-6.053)and recurrence(OR=13.983,95%CI=2.821-49.307)were independent predictors of mortality for elderly patients with cerebral infarction(P<0.05).Conclusion Fatigue after acute stroke can effect the functional recovery and survival of elderly patients with cerebral infarction.