加纳一家三级医院糖尿病患者和非糖尿病患者的中风预后及决定因素。

IF 1.8 Q3 PERIPHERAL VASCULAR DISEASE Stroke Research and Treatment Pub Date : 2018-09-12 eCollection Date: 2018-01-01 DOI:10.1155/2018/7521351
Josephine Akpalu, Alfred E Yawson, Foster Osei-Poku, Yacoba Atiase, Ernest Yorke, Patrick Adjei, Kodwo Nkromah, Albert Akpalu
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引用次数: 0

摘要

背景:糖尿病是公认的脑卒中独立危险因素,但以往的研究表明,糖尿病与脑卒中结果的关系各不相同。本研究调查了加纳一家三级医院中患有和未患有糖尿病的中风患者的中风预后及其决定因素:方法:对加纳一家三级医院收治的中风患者中患有和未患有糖尿病的患者进行前瞻性研究。记录了基线临床和生化数据。在中风后 1 个月、3 个月和 6 个月,使用改良的 Rankin 量表对中风的功能性结果进行评估:结果:参与研究的人数为 326 人,其中 105 人(32.20%)患有糖尿病。与非糖尿病患者(70.13%、65.16%、61.99%)相比,糖尿病患者在中风后 1、3 和 6 个月的功能预后较差的比例较高(79%、75.23%、73.33%)(P>0.05)。与非糖尿病患者相比,患有糖尿病的脑卒中患者存活率较低(P=0.0745)。与非糖尿病患者相比,患有糖尿病的缺血性卒中患者在 6 个月时的死亡率更高(Odds Ratio 2.037; CI: 1.058-3.923)。糖尿病患者功能性卒中不良预后的决定因素包括年龄较大(调整后比值比 (AOR)-1.07;CI-1.03-1.12)、女性(AOR-3.74;CI-1.26-12.65)和肺炎(AOR-11.32;CI-1.93-220.05),而非糖尿病患者的决定因素是失业(AOR-4.19;CI-1.24-19.50)、语言异常(AOR-1.99;CI1.08-3.73)和肺炎(AOR-4.05;CI-1.83-9.77)。高空腹血浆葡萄糖(HR-1.15;CI-1.07-1.23)、体温升高(HR-1.41;CI-1.11-1.79)和肺炎(HR-2.25;CI-1.44-3.50)是所有卒中患者存活率低的决定因素:结论:与非糖尿病患者相比,加纳籍中风患者的功能预后和存活率呈下降趋势。高龄、女性、肺炎、体温升高和空腹血浆葡萄糖是糖尿病中风患者不良预后的决定因素。
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Stroke Outcome and Determinants among Patients with and without Diabetes in a Tertiary Hospital in Ghana.

Background: Diabetes mellitus, a well-established independent risk factor for stroke, has varied association with stroke outcome from previous studies. This study investigated stroke outcome and determinants among patients with and without diabetes in a tertiary hospital in Ghana.

Methods: A prospective study conducted among stroke patients with and without diabetes admitted in a Ghanaian tertiary hospital. Baseline clinical and biochemical data were documented. Functional stroke outcome was evaluated at 1, 3, and 6 months after stroke using the modified Rankin Scale.

Results: Number of participants enrolled were 326 and 105 (32.20%) had diabetes. Higher proportions of diabetes patients had poor functional stroke outcome at 1, 3, and 6 months (79%, 75.23%, 73.33%) compared with those without diabetes (70.13%, 65.16, 61.99) (p>0.05). Stroke patients with diabetes had lower survival compared with those without diabetes (p=0.0745). Mortality at 6 months was more likely among ischaemic stroke patients with diabetes compared with those without diabetes (Odds Ratio 2.037; CI: 1.058-3.923). Determinants of poor functional stroke outcome for diabetes patients were older age (Adjusted Odds Ratio (AOR)-1.07; CI-1.03-1.12), female gender (AOR-3.74; CI-1.26-12.65), and pneumonia (AOR-11.32; CI-1.93-220.05) whereas the determinants for those without diabetes were unemployment (AOR-4.19; CI-1.24-19.50), speech abnormalities (AOR-1.99; CI1.08-3.73), and pneumonia (AOR-4.05; CI-1.83-9.77). High fasting plasma glucose (HR-1.15; CI-1.07-1.23), elevated temperature (HR-1.41; CI-1.11-1.79), and pneumonia (HR-2.25; CI-1.44-3.50) were determinants of low survival among all stroke patients.

Conclusion: Trends towards poorer functional outcome and reduced survival were found among Ghanaian stroke patients with diabetes compared with those without diabetes. Older age, female gender, pneumonia, elevated temperature, and fasting plasma glucose were determinants of adverse outcome in stroke patients with diabetes.

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来源期刊
Stroke Research and Treatment
Stroke Research and Treatment PERIPHERAL VASCULAR DISEASE-
CiteScore
3.20
自引率
0.00%
发文量
14
审稿时长
12 weeks
期刊最新文献
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