Association between edaravone use and activities of daily living in older patients with atherothrombotic stroke: an observational study using Japanese real-world data.

IF 3.4 2区 医学 Q2 GERIATRICS & GERONTOLOGY
Yukari Ogawa, Hiroko Akiyama, Takeshi Horii, Kiyoshi Mihara
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引用次数: 0

Abstract

Background: Edaravone is marketed in nine countries, although only Japan has approved edaravone for improvement of neurological symptom, disability of activities of daily living (ADL), and functional disability associated with acute stroke. This study aimed to elucidate the association of edaravone use with ADL using real-world data of older patients with atherothrombotic stroke.

Methods: This retrospective observational research using the Medical Data Vision database in Japan included patients aged 65 years and older who had acute ischemic stroke of the atherothrombotic subtype. Primary outcome was ADL improvement defined as change in Barthel Index from admission to discharge of greater than zero points. The major secondary outcome was good functional outcome (Barthel Index ≥ 90 or modified Rankin Scale 0-2 at discharge). Multivariate logistic regression analyses were conducted to calculate odds ratios with 95% confidence intervals for the outcomes. We further compared the change in Barthel Index from admission to discharge and in-hospital death rate between the edaravone- and non-edaravone- treated patients.

Results: A total of 5,576 patients were included in this study, and were divided into edaravone group (n = 3,825) and non-edaravone group (n = 1,751). The median age of this cohort was 79 years, and median Barthel Index at admission was 30 points. Edaravone use was associated with improved ADL with an adjusted odds ratio of 1.18 (95% confidence interval: 1.01‒1.37). However, no significant association was observed between edaravone use and good functional outcome. The edaravone group had significantly greater change in Barthel Index from admission to discharge than the non-edaravone group, with a difference of 5 points. The in-hospital death rate was comparable between the two groups.

Conclusions: Edaravone use may contribute to improve ADL at discharge in patients aged 65 years and older with atherothrombotic stroke.

依达拉奉使用与老年动脉粥样硬化性卒中患者日常生活活动之间的关系:一项使用日本真实世界数据的观察性研究
背景:依达拉奉在9个国家上市,尽管只有日本批准依达拉奉用于改善神经系统症状、日常生活活动障碍(ADL)和急性卒中相关的功能障碍。本研究旨在利用老年动脉粥样硬化性卒中患者的真实数据阐明依达拉奉与ADL的关系。方法:这项回顾性观察研究使用日本医学数据视觉数据库,包括65岁及以上的动脉粥样硬化血栓亚型急性缺血性卒中患者。主要终点是ADL改善,定义为Barthel指数从入院到出院的变化大于0分。主要次要指标为良好的功能预后(出院时Barthel指数≥90或改良Rankin量表0-2)。进行多变量logistic回归分析,以95%置信区间计算结果的优势比。我们进一步比较了接受依达拉奉和未接受依达拉奉治疗的患者从入院到出院的Barthel指数变化和住院死亡率。结果:共纳入5576例患者,分为依达拉奉组(n = 3825)和非依达拉奉组(n = 1751)。该队列患者的年龄中位数为79岁,入院时Barthel指数中位数为30分。使用依达拉奉与改善ADL相关,校正优势比为1.18(95%可信区间:1.01-1.37)。然而,在依达拉奉的使用和良好的功能预后之间没有观察到显著的关联。依达拉奉组入院至出院Barthel指数的变化明显大于非依达拉奉组,差异为5分。两组的住院死亡率具有可比性。结论:使用依达拉奉可能有助于改善65岁及以上动脉粥样硬化性卒中患者出院时的ADL。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Geriatrics
BMC Geriatrics GERIATRICS & GERONTOLOGY-
CiteScore
5.70
自引率
7.30%
发文量
873
审稿时长
20 weeks
期刊介绍: BMC Geriatrics is an open access journal publishing original peer-reviewed research articles in all aspects of the health and healthcare of older people, including the effects of healthcare systems and policies. The journal also welcomes research focused on the aging process, including cellular, genetic, and physiological processes and cognitive modifications.
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