Gait speed after mild stroke/transient ischemic attack was associated with long-term adverse outcomes: A cohort study

IF 3.9 2区医学 Q1 CLINICAL NEUROLOGY Annals of Clinical and Translational Neurology Pub Date : 2024-10-11 DOI:10.1002/acn3.52222

Ning Li, Jia Zhang, Yang Du, Jing Li, Anxin Wang, Xingquan Zhao

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Abstract

Objective

The association between gait speed and adverse outcomes after stroke has not been fully illustrated. This study aimed to explore the association of gait speed on long-term outcomes in minor stroke or transient ischemic attack (TIA).

Methods

We performed a longitudinal study with acute minor stroke or TIA based on a subgroup of the Third China National Stroke Registry data. The gait speed was evaluated using a 10-meter walking test at discharge and 3 months after the stroke onset. The primary outcomes were poor functional outcomes at 1 year, defined by a modified Rankin Score (mRS) of 2–6. Additional outcomes included all-cause death, ambulate dependency (mRS score 4–6), cognitive impairment (Montreal Cognitive Assessment <26), stroke recurrence, and composite vascular events.

Results

The study sample included a total of 1542 stroke patients with a median age of 60 (53–68). At 1-year follow-up, 140 (9.20%) patients experienced poor functional outcomes. Faster gait speed at discharge was associated with lower incidence of poor functional outcome (OR = 0.89; 95% CI, 0.84–0.94), cognitive impairment (OR = 0.93; 95% CI, 0.89–0.96), ischemic stroke recurrence (HR = 0.92; 95% CI, 0.87–0.98), and composite vascular events (HR =0.94; 95% CI, 0.89–0.99) at 1 year. Faster gait speed at 3 months was associated with lower incidence of poor functional outcome (OR = 0.90; 95% CI, 0.85–0.95), ambulate dependency (OR = 0.86; 95% CI, 0.77–0.97), and cognitive impairment (OR = 0.92; 95% CI, 0.88–0.95) at 1 year.

Interpretation

Our findings indicated that slow gait speed after minor stroke or TIA may be an independent predictor for long-term poor outcomes. Gait speed may be considered as a vital sign during follow-up in post-stroke patients.

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轻度中风/短暂性脑缺血发作后的步速与长期不良预后有关：一项队列研究。

目的：步态速度与脑卒中后不良预后之间的关系尚未得到充分说明。本研究旨在探讨步速与轻微脑卒中或短暂性脑缺血发作（TIA）长期预后的关系：方法：我们基于第三届中国全国卒中登记数据的一个亚组，对急性轻微卒中或 TIA 患者进行了一项纵向研究。在卒中患者出院时和卒中发生后 3 个月，我们使用 10 米步行测试对其步速进行了评估。主要研究结果为1年后的不良功能预后，即改良Rankin评分（mRS）为2-6分。其他结果包括全因死亡、行动依赖（mRS 评分 4-6 分）、认知障碍（蒙特利尔认知评估结果）：研究样本共包括 1542 名中风患者，中位年龄为 60 岁（53-68 岁）。在 1 年的随访中，有 140 名（9.20%）患者出现功能障碍。出院时步速越快，1 年后不良功能预后（OR = 0.89；95% CI，0.84-0.94）、认知障碍（OR = 0.93；95% CI，0.89-0.96）、缺血性卒中复发（HR = 0.92；95% CI，0.87-0.98）和复合血管事件（HR = 0.94；95% CI，0.89-0.99）的发生率越低。3个月时较快的步态速度与1年后较低的不良功能预后（OR = 0.90; 95% CI, 0.85-0.95）、行走依赖（OR = 0.86; 95% CI, 0.77-0.97）和认知障碍（OR = 0.92; 95% CI, 0.88-0.95）发生率相关：我们的研究结果表明，轻微卒中或 TIA 后步速缓慢可能是长期不良预后的独立预测因素。我们的研究结果表明，轻微卒中或 TIA 后步态速度缓慢可能是长期不良预后的独立预测因素，步态速度可被视为卒中后患者随访期间的重要体征。

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来源期刊

Annals of Clinical and Translational Neurology Medicine-Neurology (clinical)

CiteScore

9.10

自引率

1.90%

发文量

218

审稿时长

8 weeks

期刊介绍： Annals of Clinical and Translational Neurology is a peer-reviewed journal for rapid dissemination of high-quality research related to all areas of neurology. The journal publishes original research and scholarly reviews focused on the mechanisms and treatments of diseases of the nervous system; high-impact topics in neurologic education; and other topics of interest to the clinical neuroscience community.