Stroke:卒中康复后功能结局的预测模型!

2017-10-22 MedSci MedSci原创

卒中康复后的预后可以帮助临床医师进行康复护理的相关决策和规划。近期,一项发表在杂志Stroke上的研究开发和验证了一种预测工具,用于估计在卒中康复后实现身体功能改善的可能性(模型1)以及仅仅需要监督的一定程度的独立(模型2)。此项研究的模型来自717例入院的中风康复患者。研究者们使用多变量逻辑回归分析来构建每个模型。然后,每个模型在875例患者中进行前瞻性验证。此项研究结果显示:模型1包括了年龄,

卒中康复后的预后可以帮助临床医师进行康复护理的相关决策和规划。近期,一项发表在杂志Stroke上的研究开发和验证了一种预测工具,用于估计在卒中康复后实现身体功能改善的可能性(模型1)以及仅仅需要监督的一定程度的独立(模型2)。


此项研究的模型来自717例入院的中风康复患者。研究者们使用多变量逻辑回归分析来构建每个模型。然后,每个模型在875例患者中进行前瞻性验证。

此项研究结果显示:模型1包括了年龄,从发生卒中到康复入院的时间,入院运动和认知功能独立度量评分以及忽视。模型2包括了年龄,男性,中风发作后的时间,以及入院运动和认知功能独立度量评分。两种模型都表现出极好的辨别力。

在推导队列中,模型1的曲线下面积为0.883(95%置信区间,0.858-0.910),模型2为0.913(95%置信区间,0.884-0.942)。Hosmer-Lemeshowχ2分别为4.12(P = 0.249)和1.20(P = 0.754)。

在验证队列中,模型1的曲线下面积为0.866(95%置信区间,0.840-0.892),模型2为0.850(95%置信区间,0.815-0.885)。Hosmer-Lemeshowχ2分别为8.86(P = 0.115)和34.50(P = 0.001)。身体功能(风险比,0.43;0.25-0.71;P = 0.001)和仅需要监督的独立性水平的改善(风险比,0.32;0.14-0.68;P = 0.004)与4年生存的改善独立相关。计算公式可免费下载,网址为https://goo.gl/fEAp81。

此项研究为研究人员和临床医生提供了易于使用以及准确有效的预测工具,用于康复研究和卒中的管理中。

原始出处:
Scrutinio D, Lanzillo B, et al. Development and Validation of a Predictive Model for Functional Outcome After Stroke Rehabilitation: The Maugeri Model. Stroke. 2017 Oct 19. pii: STROKEAHA.117.018058. doi: 10.1161/STROKEAHA.117.018058.

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    2017-10-22 天涯183

    非常好的文章.学习了

    0

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    2017-10-22 清风拂面

    谢谢分享.学习了

    0

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    2017-10-22 183****7028

    学习

    0

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