BMJ Open:卒中后1年花费及患者生活质量的调查

2015-12-03 phylis 译 MedSci原创

目标:评估和探索卒中后1年(1)社会花费(2)花费及生活质量(QoL)的改变(3)花费和生活质量之间的关系。设计:目前主要研究卒中后的花费及QoL设置:医院卒中单元的卒中患者,并对其随访1年。参与者:395例脑卒中患者。主要预后指标:花费及QoL方法:花费分类由自低向上的方法确定。应用荷兰-三维5维度欧洲QoL计算QoL。应用非参数逐步法计算花费的统计差异。亚组分析识别花费和QoL的预测因子。通过

目标:评估和探索卒中后1年,社会花费及生活质量(QoL)的改变,以及花费和生活质量之间的关系。

设计:目前主要研究卒中后的花费及QoL

设置:医院卒中单元的卒中患者,并对其随访1年。

参与者:395例脑卒中患者。

主要预后指标:花费及QoL

方法:花费分类由自低向上的方法确定。应用荷兰-三维5维度欧洲QoL计算QoL。应用非参数逐步法计算花费的统计差异。亚组分析识别花费和QoL的预测因子。通过敏感性测试结果的稳定性。

结果:卒中后1年的总社会花费为€29 484(n = 352),74%的花费在前6个月。随时间变化,QoL保持稳定。花费和QoL的预测因子是出院位置;男性比女性的QoL较高,年轻患者(<65)比老年患者(>65)的花费较高。EQ-5D-3L的各维度都存在天花板效应。花费和QoL相关性较低(r=-0.29)。敏感分析显示鲁棒性结果。

结论:研究者患者较低的花费与较高的QoL相关。这可能是由研究人群的健康状态及荷兰医疗保健系统改变,使得卒中后住院时间较短来解释。由于天花板效应,未来的研究必须质疑相同人群EQ-5D-3L的使用。

原文出处:

van Eeden M, van Heugten C, van Mastrigt GA, et al. The burden of stroke in the Netherlands: estimating quality of life and costs for 1 year poststroke. BMJ Open. 2015 Nov 27


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  2. [GetPortalCommentsPageByObjectIdResponse(id=1671219, encodeId=c30c16e121995, content=<a href='/topic/show?id=9f4e360191a' target=_blank style='color:#2F92EE;'>#卒中后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36019, encryptionId=9f4e360191a, topicName=卒中后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff7426824786, createdName=waiwai3039, createdTime=Mon Apr 11 17:36:00 CST 2016, time=2016-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847788, encodeId=3382184e78844, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Mon Oct 24 06:36:00 CST 2016, time=2016-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725954, encodeId=08151e259543f, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Tue Dec 22 23:36:00 CST 2015, time=2015-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48960, encodeId=d8f74896086, content=好文章,值得收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=173, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sun Dec 27 08:40:00 CST 2015, time=2015-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48961, encodeId=70a748961cf, content=好文章,值得收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sun Dec 27 08:40:00 CST 2015, time=2015-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44738, encodeId=dd9f44e386b, content=康复科的优势, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Fri Dec 04 12:20:00 CST 2015, time=2015-12-04, status=1, ipAttribution=)]
    2016-10-24 gaoxiaoe
  3. [GetPortalCommentsPageByObjectIdResponse(id=1671219, encodeId=c30c16e121995, content=<a href='/topic/show?id=9f4e360191a' target=_blank style='color:#2F92EE;'>#卒中后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36019, encryptionId=9f4e360191a, topicName=卒中后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff7426824786, createdName=waiwai3039, createdTime=Mon Apr 11 17:36:00 CST 2016, time=2016-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847788, encodeId=3382184e78844, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Mon Oct 24 06:36:00 CST 2016, time=2016-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725954, encodeId=08151e259543f, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Tue Dec 22 23:36:00 CST 2015, time=2015-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48960, encodeId=d8f74896086, content=好文章,值得收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=173, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sun Dec 27 08:40:00 CST 2015, time=2015-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48961, encodeId=70a748961cf, content=好文章,值得收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sun Dec 27 08:40:00 CST 2015, time=2015-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44738, encodeId=dd9f44e386b, content=康复科的优势, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Fri Dec 04 12:20:00 CST 2015, time=2015-12-04, status=1, ipAttribution=)]
    2015-12-22 仁医06
  4. [GetPortalCommentsPageByObjectIdResponse(id=1671219, encodeId=c30c16e121995, content=<a href='/topic/show?id=9f4e360191a' target=_blank style='color:#2F92EE;'>#卒中后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36019, encryptionId=9f4e360191a, topicName=卒中后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff7426824786, createdName=waiwai3039, createdTime=Mon Apr 11 17:36:00 CST 2016, time=2016-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847788, encodeId=3382184e78844, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Mon Oct 24 06:36:00 CST 2016, time=2016-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725954, encodeId=08151e259543f, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Tue Dec 22 23:36:00 CST 2015, time=2015-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48960, encodeId=d8f74896086, content=好文章,值得收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=173, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sun Dec 27 08:40:00 CST 2015, time=2015-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48961, encodeId=70a748961cf, content=好文章,值得收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sun Dec 27 08:40:00 CST 2015, time=2015-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44738, encodeId=dd9f44e386b, content=康复科的优势, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Fri Dec 04 12:20:00 CST 2015, time=2015-12-04, status=1, ipAttribution=)]
    2015-12-27 hixiaoluo

    好文章,值得收藏

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1671219, encodeId=c30c16e121995, content=<a href='/topic/show?id=9f4e360191a' target=_blank style='color:#2F92EE;'>#卒中后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36019, encryptionId=9f4e360191a, topicName=卒中后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff7426824786, createdName=waiwai3039, createdTime=Mon Apr 11 17:36:00 CST 2016, time=2016-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847788, encodeId=3382184e78844, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Mon Oct 24 06:36:00 CST 2016, time=2016-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725954, encodeId=08151e259543f, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Tue Dec 22 23:36:00 CST 2015, time=2015-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48960, encodeId=d8f74896086, content=好文章,值得收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=173, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sun Dec 27 08:40:00 CST 2015, time=2015-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48961, encodeId=70a748961cf, content=好文章,值得收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sun Dec 27 08:40:00 CST 2015, time=2015-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44738, encodeId=dd9f44e386b, content=康复科的优势, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Fri Dec 04 12:20:00 CST 2015, time=2015-12-04, status=1, ipAttribution=)]
    2015-12-27 hixiaoluo

    好文章,值得收藏

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1671219, encodeId=c30c16e121995, content=<a href='/topic/show?id=9f4e360191a' target=_blank style='color:#2F92EE;'>#卒中后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36019, encryptionId=9f4e360191a, topicName=卒中后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff7426824786, createdName=waiwai3039, createdTime=Mon Apr 11 17:36:00 CST 2016, time=2016-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847788, encodeId=3382184e78844, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Mon Oct 24 06:36:00 CST 2016, time=2016-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725954, encodeId=08151e259543f, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Tue Dec 22 23:36:00 CST 2015, time=2015-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48960, encodeId=d8f74896086, content=好文章,值得收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=173, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sun Dec 27 08:40:00 CST 2015, time=2015-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48961, encodeId=70a748961cf, content=好文章,值得收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sun Dec 27 08:40:00 CST 2015, time=2015-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44738, encodeId=dd9f44e386b, content=康复科的优势, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Fri Dec 04 12:20:00 CST 2015, time=2015-12-04, status=1, ipAttribution=)]
    2015-12-04 老段

    康复科的优势

    0

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背景和目的:出血性转化(HT)在急性缺血性卒中后较为常见。肝功能在HT中的作用仍是一个悬而未决的问题。方法:招募卒中开始7天的急性缺血性卒中患者。收集基线数据,包括肝功能检查。应用多变量回归模型识别卒中及卒中各类型间肝功能和HT的相关性。结果:共有2788例患者。277例(9.9%)发生HT,其中32例(1.1%)患者为有症状的HT和245例(8.8%)患者无症状HT。在多元回归分析中,天门冬氨酸

Stroke:卒中早期、晚期再发率及预测因子研究(NDPSS研究)

背景和目的:最近几项研究应用前瞻性基于人群的方法学,调查了早期和晚期卒中再发率及预测因子。研究者调查了北都柏林人群卒中研究(NDPSS)中2年内卒中再发。方法:2005年12月到2006年间,招募了社区和医院的患者。确定患者72小时、7天、28天、90天、1年、2年,脑卒中复发、生存期及功能性预后。结果:567例患者中,累计2年卒中复发率为10.8%,病死率为38.6%。复发卒中亚型与初发卒中亚型

Stroke:卒中位置是认知预后的独立预测因子

背景和目的:准确预测脑卒中患者认知预后是对临床管理有重要的影响。研究者调查卒中部位是否可预测多因素预测模型中的功能和认知预后。方法:共有428名缺血性卒中患者,在卒中发生24到72h内对其进行MRI检测,3个月时,应用mRS评估患者功能预后,应用蒙特利尔认知评估量表(MoCA)评估认知预后。从第一批患者(215名),获得功能和认知功能区的统计地图。研究者应用多变量回归模型研究卒中区域,年龄,基线N

J Am Heart Assoc:实现“简单生活方式7”可延长卒中后生存时间

背景:美国心脏病协会制定被称为“简单生活7” 的标准,定义理想的心血管健康:不吸烟,规律体育运动,健康饮食,保持正常体重,控制胆固醇,血压和血糖水平。实现这些目标对卒中后生存的影响尚不清楚。研究者旨在确定美国卒中幸存者心血管健康分数及评估心血管健康分数及卒中后各种原因的死亡率。方法和结果:研究者评估美国成年人全国代表性的卒中患者的心血管健康分数(n = 420),这些患者参加了1988-1994年

BMC Neurol:心理社会应激是卒中发生的危险因素(meta分析)

背景:许多研究表明心理社会应激与卒中发生的风险增加,然而,有关知觉应激的定义和检测方法不同,研究设计的不同,研究实施及获得的结论不同,最后的结果也不一致,尚未有相关的meta分析发表。研究者旨在进行一项系统性综述及meta分析评估心理社会应激与卒中发生的相关性。方法:系统搜索MEDLINE,EMBASE,CINAHL,PsycINFO,和Cochrane系统评价数据库中发表在1980年到2014年