来自刚果民主共和国金沙萨三家医院的患者中风事件后致命结果的预测因素

Limbole Bakilo, DS NkarnkwinKasanza, Atheno Simele, Panzi Kalunda, Mutombo Beya, Emmanuel Limbole Bakilo
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摘要

目的:本研究对脑卒中致死性结局的预测因素进行了为期一年的随访。方法:这是来自刚果民主共和国首都金沙萨三家医院的166例中风患者的历史性队列研究。数据是在病人入院时收集的。在整个随访期间收集重要结果信息。采用Cox比例风险模型测量预测因子。结果:患者中位年龄59岁(IQR: 52 ~ 68岁)。其中男性居多(65.1%),已知高血压(79.5%)。约31%的患者在1年随访期内死亡;卒中发生至死亡的中位持续时间为37(14-155.5)天。格拉斯哥昏迷评分和第7天血糖对生命结局有显著影响:早期意识障碍(格拉斯哥评分小于13)使死亡风险增加2.5倍(HR: 2.46, 95% CI [1.3-4.6], p = 0.005),第7天血糖水平大于或等于180 mg / dl使死亡风险增加2.4倍(HR: 2.4, 95% CI [1.03 -5.7], p = 0.04)。结论:脑卒中急性期高血糖和早期意识障碍是脑卒中致死性预后的预测因素,在常规临床实践中易于发现。因此,它们应用于识别短期和长期预后可能较差的患者,以便进行适当的护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predictors of Fatal Outcome after Incident of Stroke among Patients from Three Hospitals in Kinshasa, Democratic Republic of the Congo
Summary Objective: This study investigated the predictors of stroke fatal outcome after a one year follow-up. Methods: This was a historic cohort of 166 stroke patients from three hospitals in Kinshasa, capital of the Democratic Republic of Congo. Data were collected from patients as they were admitted. Vital outcome information was collected throughout the follow-up period. The Cox proportional hazard modeling was used to measure predictors. Results: The patients’ median age was 59 (IQR: 52-68) years. The majority of them were male (65.1%) and known hypertensive (79.5%). Around 31% patients died within the one year period of follow-up; the median duration between the occurrence of stroke and death was 37 (14-155.5) days. The Glasgow Coma Score and day 7 blood glucose showed a significant influence on vital outcome: an early disorder of consciousness (Glasgow score ˂13) multiplies by 2.5 the risk of death (HR: 2.46, 95% CI [1.3-4.6], p = 0.005) and the glycaemia level at day 7 greater than or equal to 180 mg / dl increases the risk of death by 2.4 times (HR: 2.4, 95% CI [1.03 -5.7], p = 0.04). Conclusion: Hyperglycemia in the acute phase of stroke and early consciousness disorder are predictors of fatal prognosis of stroke, easy to detect in routine clinical practice. They should therefore be used to identify patients with potentially poor prognosis in the short and in the long term for appropriate care.
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