作者：施杨，顾志娥，王林

单位：

1.225003江苏省扬州市，江苏省扬州五台山医院康复科　2.225009江苏省扬州市，扬州大学护理学院·公共卫生学院3.225001江苏省扬州市，苏北人民医院教育培训处

Units：

1.Department of Rehabilitation, Wutaishan Hospital, Yangzhou, Jiangsu Province, Yangzhou 225003, China2.School of Nursing·School of Public Health, Yangzhou University, Yangzhou 225009, China3.Department of Education and Training Division, Subei People's Hospital, Yangzhou 225001, China

关键词：

卒中；老年人；衰弱；神经功能结局

Keywords：

Stroke; Aged; Frailty; Neurological outcome

CLC：

R 743

DOI：

10.12114/j.issn.1008-5971.2023.00.259

Funds：

江苏省人兽共患病学重点实验室“护馨基金”项目（HX2104）；江苏省扬州五台山医院2022年度院级科研课题（WTS2022010）

摘要：

目的　分析老年急性脑卒中患者衰弱发生情况及其与神经功能结局的关系。方法　选取2021年2月至2023年2月江苏省扬州五台山医院和苏北人民医院收治的老年急性脑卒中患者188例为研究对象。收集患者一般资料。根据临床衰弱量表（CFS）评分将患者分为衰弱组（≥5分，62例）和非衰弱组（＜5分，126例）。根据改良Rankin量表（mRS）评分将患者分为结局不良组（＞2分，33例）和结局良好组（≤2分，155例）。采用Kaplan-Meier法绘制生存曲线，生存曲线比较采用Log-rank检验；采用多因素Logistic回归分析探讨老年急性脑卒中患者神经功能结局的影响因素。结果　衰弱组年龄大于非衰弱组，入院时美国国立卫生研究院卒中量表（NIHSS）评分高于非衰弱组（P＜0.05）。生存曲线分析结果显示，衰弱组神经功能预后不良发生率高于非衰弱组（P＜0.05）。结局不良组年龄大于结局良好组，入院时NIHSS评分、衰弱发生率高于结局良好组（P＜0.05）。多因素Logistic回归分析结果显示，衰弱是老年急性脑卒中患者神经功能结局不良的危险因素〔OR=3.415，95%CI（1.415，8.244），P＜0.05〕。结论　老年急性脑卒中患者衰弱发生率为33.0%，且衰弱是老年急性脑卒中患者神经功能结局不良的危险因素。

Abstract：

Objective To analyze the incidence of frailty and its relationship with neurological outcomes in elderlypatients with acute stroke. Methods A total of 188 elderly acute stroke patients admitted to Wutaishan Hospital, Yangzhou,Jiangsu Province and Subei People's Hospital from February 2021 to February 2023 were selected as the study objects. Generaldata of patients were collected. According to Clinical Frailty Scale (CFS) score, patients were divided into frailty group ( ≥ 5points, 62 cases) and non-frailty group ( < 5 points, 126 cases) . According to the modified Rankin Scale (mRS) score, the patientswere divided into poor outcome group ( > 2 points, 33 cases) and good outcome group ( ≤ 2 points, 155 cases) . Kaplan-Meiermethod was used to draw survival curves, and Log-rank test was used to compare survival curves. Multivariate Logistic regressionanalysis was used to explore the influencing factors of neurological outcomes in elderly patients with acute stroke. Results Theage of the frailty group was older than that of the non-frailty group, and the National Institutes of Health Stroke Scale (NIHSS)score at admission was higher than that of the non-frailty group (P < 0.05) . Survival curve analysis showed that the incidenceof poor neurological prognosis in the frailty group was higher than that in the non-frailty group (P < 0.05) . The age of the pooroutcome group was older than that of the good outcome group, and the NIHSS score at admission and frailty incidence were higherthan those of the good outcome group (P < 0.05) . Multivariate Logistic regression analysis showed that frailty was a risk factor forpoor neurological outcomes in elderly patients with acute stroke [OR=3.415, 95%CI (1.415, 8.244) , P < 0.05] . ConclusionThe incidence of frailty in elderly patients with acute stroke is 33.0%, and frailty is a risk factor for poor neurological outcomes inelderly patients with acute stroke.

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