摘要
目的对住院缺血型脑卒中患者进行随访,描述患者病后生存状况,并分析影响死亡的危险因素。方法回顾性收集2002年1月至2005年6月第四军医大学西京医院神经内科确诊的617例连续性缺血型脑卒中病例,采用电话、信访等方式随访患者的生存状况及死亡原因,2006年1月完成随访工作。应用Kaplan-Meier法进行生存率分析,采用Cox比例风险回归模型对影响患者死亡的危险因素进行单因素和多因素分析。结果随访时间最长47个月,失访59例（9．5%）。随访期间死亡80例,其中缺血型脑卒中60例,脑出血3例,心脏病10例,其他死因7例,中位生存时间42．16月。患者1、2、3年生存率分别为91．9%、89．4%、85．3%。单因素及多因素Cox比例风险模型显示,影响缺血型脑卒中患者死亡的主要危险因素有：高龄（RR=1．043,95%CI：1．013～1．074）, Glasgow评分低（RR=O．855,95%CI：0．742～0．985）,意识水平差（RR=4．085,95%CI：2．128～7．844）和存在并发症（RR=1．765,95%CI：1．108～2．812）。结论高龄、Glasgow评分低、意识水平差和存在并发症是缺血型脑卒中患者死亡的主要危险因素。
Objective The purpose of this study was to describe survival status and risk factors of mortality on inpatients with ischemic stroke. Methods 617 patients with continuous ischemic stroke cases were collected from January 2002 to June 2005 retrospectively in the Department of Neurology, Xijing Hospital, Fourth Military Medical University. In order to perceive relevant information on survival and the cause of death. All patients were followed through phone calls or mailing. The follow-up program was completed in January 2006. Kaplan-Meier methods were used for survival description. Monovariant and multivariant Cox＇s proportional hazard regression model were used to analyze prognostic factors on mortality. Results The longest time in the follow-up program was 47 months with 59 dropped-out cases, making the dropout rate as 9.5%. Of these patients, 80 cases died during the period of study（60 for ischemic stroke,3 for cerebral hemorrhage, 10 for cardiac disease, 7 for other cause）. The median survival time was 42.16 months. The survival rates of one-year, two-year and three-year period were 91.9%, 89.4 % and 85.3 %, respectively. Monovariant and multivariant Cox＇s proportional hazard regression model showed that the risk factors associated with mortality were old age（ RR = 1. 043,95 % CI ： 1. 013-1. 074 ）, lower Glasgow scores（ RR = 0. 855,95 % CI ： 0. 742-0. 985 ）, poor conscious levels（ RR = 4. 085,95 % CI ： 2. 128-7. 844） and having complication（RR = 1. 765,95 % CI ： 1. 108-2. 812）. Conclusion The results of this study suggested that the risk factors were old age, lower Glasgow scores, poor conscious levels and having complication on mortality of ischemic stroke.
出处
《中华流行病学杂志》
CAS
CSCD
北大核心
2007年第4期390-393,共4页
Chinese Journal of Epidemiology
关键词
缺血型脑卒中
随访研究
预后
生存分析
Ischemic stroke
Follow-up study
Prognosis
Survival analysis
