Health outcomes after acute ischemic stroke:retrospective and survival analysis from Oman.

IF 1.5 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Annals of Saudi Medicine Pub Date : 2022-07-01 Epub Date: 2022-08-04 DOI:10.5144/0256-4947.2022.269
Abdullah M Al Alawi, Ikhlas Al Busaidi, Emaad Al Shibli, Al-Reem Al-Senaidi, Shahd Al Manwari, Ibtisam Al Busaidi, Fatema Muhanna, Ahmed Al Qassabi
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引用次数: 5

Abstract

Background: Stroke mortality and related functional disability have been declining over the last two decades, but stroke continues to represent the second leading cause of cardiovascular death worldwide and the number one cause for acquired long-term disability.

Objectives: Assess short- and long-term health outcomes after acute ischemic stroke and analyze factors associated with poor survival and functional outcomes.

Design: Retrospective and survival analysis SETTING: Inpatient unit at a tertiary care referral hospital.

Patients and methods: All patients admitted with acute ischemic stroke from 1 January 2017 to 31 August 2018 were included in the study. Functional status was assessed using the modified Rankin Scale (mRS). Other demographic and clinical variables were obtained from medical records. Data were analyzed by multivariable logistic regression, Cox proportional hazards, and the Kaplan-Meier method. Long-term follow-up data, including mortality and mRS was collected by follow-up phone call.

Main outcome measures: Functional dependency and factors associated with mortality.

Sample size and characteristics: 110 with mean age of 67.0 (14.7) years; 59 patients (53.6%) were males.

Results: Hypertension (75.5%), diabetes mellitus (54.6%), and dyslipidemia (29.1%) were common. Sixty-five patients (59.1%) had mRS >2 upon discharge including 18 patients (16.4%) who died during the hospital stay. The cumulative mortality rate was 25.4% (28/110) at 12 months and 30.0% (33/110) at 24 months. Twenty-nine stroke survivors (29/70, 41.4%) remained physically dependent (mRS >2) at the end of follow-up. Old age, atrial fibrillation, history of prior stroke, chronic kidney disease, and peripheral arterial disease were associated with increased mortality and functional dependence.

Conclusions: Patients in Oman with acute ischemic stroke tend to have a high comorbidity burden, and their functional dependency and mortality are higher compared to patients from developed countries. Therefore, evidence-based measures such as establishing stroke units are essential to improve the health outcomes of patients with acute ischemic stroke.

Limitations: Retrospective at single center.

Conflict of interest: None.

Abstract Image

Abstract Image

急性缺血性卒中后的健康结果:来自阿曼的回顾性和生存分析
背景:在过去的二十年中,卒中死亡率和相关的功能残疾一直在下降,但卒中仍然是世界范围内心血管死亡的第二大原因,也是获得性长期残疾的第一大原因。目的:评估急性缺血性卒中后的短期和长期健康结果,并分析与生存不良和功能预后相关的因素。设计:回顾性和生存分析设置:一家三级转诊医院的住院病房。患者和方法:2017年1月1日至2018年8月31日入院的所有急性缺血性脑卒中患者纳入研究。采用改良Rankin量表(mRS)评估功能状态。其他人口统计学和临床变量从医疗记录中获得。采用多变量logistic回归、Cox比例风险和Kaplan-Meier法对数据进行分析。通过随访电话收集长期随访数据,包括死亡率和mRS。主要结局指标:功能依赖和与死亡率相关的因素。样本量和特征:110例,平均年龄67.0(14.7)岁;男性59例(53.6%)。结果:高血压(75.5%)、糖尿病(54.6%)、血脂异常(29.1%)较为常见。出院时mRS >2者65例(59.1%),其中住院期间死亡18例(16.4%)。12个月的累计死亡率为25.4%(28/110),24个月的累计死亡率为30.0%(33/110)。29名脑卒中幸存者(29/70,41.4%)在随访结束时仍有身体依赖(mRS >2)。老年、房颤、既往卒中史、慢性肾脏疾病和外周动脉疾病与死亡率和功能依赖增加相关。结论:阿曼急性缺血性脑卒中患者往往有较高的合并症负担,其功能依赖性和死亡率高于发达国家患者。因此,建立卒中单元等循证措施对于改善急性缺血性卒中患者的健康结果至关重要。局限性:单中心回顾性研究。利益冲突:无。
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来源期刊
Annals of Saudi Medicine
Annals of Saudi Medicine 医学-医学:内科
CiteScore
2.80
自引率
0.00%
发文量
44
审稿时长
4-8 weeks
期刊介绍: The Annals of Saudi Medicine (ASM) is published bimonthly by King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. We publish scientific reports of clinical interest in English. All submissions are subject to peer review by the editorial board and by reviewers in appropriate specialties. The journal will consider for publication manuscripts from any part of the world, but particularly reports that would be of interest to readers in the Middle East or other parts of Asia and Africa. Please go to the Author Resource Center for additional information.
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