上海市松江区缺血性脑卒中患者急性期治疗后死亡危险因素回顾性研究

目的 对上海市松江区某三级综合性医院（A院）和某二级综合性医院（B院）自2009年1月1日～2011年1月1日期间入院治疗的新发缺血性脑卒中病例进行随访,描述患者预后生存情况,同时分析死亡危险因素.方法 以问卷调查的形式随访患者所在社区医生.随访至2012年1月.采用Kaplan-Meier法分析生存率,生存曲线比较采用Log-Rank检验,危险因素分析采用Cox比例风险模型分析.结果 随访时间最长为35个月,平均随访时间为22.4个月,失访32例,死亡85例,患者1年、2年、3年生存率分别为为89％、80％、61％.结论 高龄、急性期出院NIH-SS评分高和无康复干预是缺血性脑卒中患者死亡的主要危险因素.系统规范的康复治疗可有效延长患者的生存时间.

A Retrospective Study on Risk Factors of Mortality among Patients with Cerebral Ischemic Stroke after Acute-Stage Treatment in Songjiang District of Shanghai

Objective The study aimed to investigate the survival status and risk factors of mortality on new ischemic stroke patients after acute - stage treatment in a tertiary hospital （ A ） and a secondary hospital （ B ） in Songjiang District of Shanghai from I January 2009 to 1 January 2011. Method A questionnaire survey was performed among community doctors of the patients till January 2012. The Kaplan - Meier method was used for survival analysis, and survival curves were compared by log - rank test and risk factors were analyzed by Cox＇s proportional hazard model. Results The longest follow - up time was 35 months with average of 22.4 months. 32 participants were lost to follow up, and 85 participants dead. The survival rates at one, two and three years were 89% , 80% , and 61% , respectively. Result The main risk factors for death among patients with cerebral ischemic stroke were older age, discharge at acute - stage with high NIHSS score and interventions without rehabilitation. System standard rehabilitation can effectively extend the survival time.