非重度缺血性脑卒中患者复工比例

Krittin Wipahut, N. Chaiear, S. Boonjaraspinyo, K. Kongbunkiat, S. Tiamkao, W. Soonthornvinit
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摘要

目的探讨非重度缺血性脑卒中患者重返工作岗位(RTW)的比例,并探讨人口学、临床和评估信息与RTW结果的关系。方法:这项观察性研究纳入了2021年9月至2022年11月期间在泰国孔凯市斯利那加林德医院中风病房的非严重缺血性中风患者。纳入的患者年龄在18岁以上,NIHSS评分不超过14分,目前有工作并希望进行RTW。分别于出院时、2周随访和3个月随访时对患者进行评估。采用卡方检验或Fisher精确检验进行双变量分析。结果共招募64例患者,其中4例退出,共60例。RTW患者出院时、随访2周、随访1个月、随访3个月累计成功比例分别为26.7%、51.7%、70%、76.7% (95%CI 16.8 ~ 38.8、39.2 ~ 64.0、57.7 ~ 80.5、64.9 ~ 86.0)。大多数患者在第一个月可以RTW,然后在3个月时趋于平稳。更成功的RTW患者包括那些从事认知需求职业的患者,他们被评估为正常到轻微的神经严重程度,出院时运动功率等级为4-5,通过MoCA或MMSE测试,并被mRS或BI评为独立。双变量分析显示,RTW比例与职业类型、神经系统严重程度、运动力量和ADL残疾有统计学意义。结论大多数非重度缺血性脑卒中患者在出院后3个月内可实现RTW。职业类型、神经系统严重程度、运动动力和ADL与RTW比例相关(随访3个月)。非重度脑卒中患者的RTW评估应在出院后3个月内进行短间隔评估。【关键词】重返工作岗位,缺血性中风,职业,认知,日常生活活动
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Proportion of Non-severe Ischemic Stroke Patients Returning to Work
OBJECTIVE To explore the proportion of non-severe ischemic stroke patients returning to work (RTW) and to examine the association of demographic, clinical, and evaluative information with RTW outcomes. METHODS This observational study included non-severe ischemic stroke patients at the stroke ward, Srinagarind Hospital, Khon Kaen, Thailand between September 2021 and November 2022. Patients included were over 18-year-old, had NIHSS scores not exceeding 14, were currently employed and wanted to RTW. Patients were assessed at the discharged time, 2-week-follow-up, and 3-month-follow-up. Bivariate analysis was conducted using either Chi-square or Fisher’s exact test. RESULTS Sixty-four patients were recruited of whom 4 dropped out, leaving a total of 60. The cumulative proportions of successful RTW patients at the discharged time, 2-week-follow-up, 1-month-follow-up, and 3-month-follow-up were 26.7%, 51.7%, 70%, and 76.7% (95%CI 16.8-38.8, 39.2-64.0, 57.7-80.5, 64.9-86.0), respectively. Most patients could RTW in the first month, then the number plateaued at 3 months. More successful RTW patients included those in cognitive demand occupations, evaluated as normal to minor neurological severity, motor power graded 4-5 at discharge, passed MoCA or MMSE test, and who were rated as independent by either the mRS or the BI. Bivariate analysis revealed statistically significant association between RTW proportion and occupation type, neurological severity, motor power, and ADL disability. CONCLUSIONS Most non-severe ischemic stroke patients could RTW within 3 months after discharge. Occupational type, neurological severi-ty, motor power, and ADL associated with the proportion of RTW (3-month-follow-up). RTW evaluation of non-severe stroke patients should be assessed at short intervals for 3 months after discharge. KEYWORDS return to work, ischemic stroke, occupation, cognition, activities of daily living
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