Functional Disability After Ischemic Stroke: A Community-Based Cross-Sectional Study in Shanghai, China

Yao, Ying-Ye; Wei, Zijun; Zhang, Yuechan; Li, Xiang; Gong, Li; Zhou, Jiawei; Wang, Yu; Zhang, Yunyun; Wang, Ruiping

doi:10.3389/fneur.2021.649088

Cited by 33 publications

(22 citation statements)

References 44 publications

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“…The reported incidence of physical dependence among stroke survivors varies between 15-30% in the USA to 45% in China. 46 We found that old age, previous stroke, AF, and high mRS>2 at discharge were associated with an increased functional disability during the follow-up period.…”

Section: Discussionmentioning

confidence: 64%

Health outcomes after acute ischemic stroke:retrospective and survival analysis from Oman

et al. 2022

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BACKGROUND: Stroke mortality and related functional disability have been declining over the last two decades, but stroke continues to represent the second leading cause of cardiovascular death worldwide and the number one cause for acquired long-term disability. OBJECTIVES: Assess short- and long-term health outcomes after acute ischemic stroke and analyze factors associated with poor survival and functional outcomes. DESIGN: Retrospective and survival analysis SETTING: Inpatient unit at a tertiary care referral hospital. PATIENTS AND METHODS: All patients admitted with acute ischemic stroke from 1 January 2017 to 31 August 2018 were included in the study. Functional status was assessed using the modified Rankin Scale (mRS). Other demographic and clinical variables were obtained from medical records. Data were analyzed by multivariable logistic regression, Cox proportional hazards, and the Kaplan-Meier method. Long-term follow-up data, including mortality and mRS was collected by follow-up phone call. MAIN OUTCOME MEASURES: Functional dependency and factors associated with mortality. SAMPLE SIZE AND CHARACTERISTICS: 110 with mean age of 67.0 (14.7) years; 59 patients (53.6%) were males. RESULTS: Hypertension (75.5%), diabetes mellitus (54.6%), and dyslipidemia (29.1%) were common. Sixty-five patients (59.1%) had mRS >2 upon discharge including 18 patients (16.4%) who died during the hospital stay. The cumulative mortality rate was 25.4% (28/110) at 12 months and 30.0% (33/110) at 24 months. Twenty-nine stroke survivors (29/70, 41.4%) remained physically dependent (mRS >2) at the end of follow-up. Old age, atrial fibrillation, history of prior stroke, chronic kidney disease, and peripheral arterial disease were associated with increased mortality and functional dependence. CONCLUSIONS: Patients in Oman with acute ischemic stroke tend to have a high comorbidity burden, and their functional dependency and mortality are higher compared to patients from developed countries. Therefore, evidence-based measures such as establishing stroke units are essential to improve the health outcomes of patients with acute ischemic stroke. LIMITATIONS: Retrospective at single center. CONFLICT OF INTEREST: None.

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Section: Discussionmentioning

confidence: 64%

Health outcomes after acute ischemic stroke:retrospective and survival analysis from Oman

et al. 2022

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“…Cognitive function was evaluated by experienced neurological physicians using the Chinese version of the Mini-Mental State Examination (MMSE) scale 3 months after lacunar infarction ( 21 ). The MMSE scale was widely used in cognitive function assessment in China ( 22 , 23 ). The total score of MMSE was 30, and the lower scores indicated the worse cognitive function.…”

Section: Methodsmentioning

confidence: 99%

“…Radiologic images were read by a radiologist and were reviewed by an experienced neurologist. (22,23). The total score of MMSE was 30, and the lower scores indicated the worse cognitive function.…”

Section: Lacunar Infarction Definitionmentioning

confidence: 96%

High serum amyloid A predicts risk of cognitive impairment after lacunar infarction: Development and validation of a nomogram

Pan

et al. 2022

Front. Neurol.

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BackgroundPost-stroke cognitive impairment (PSCI) after lacunar infarction was worth attention in recent years. An easy-to-use score model to predict the risk of PSCI was rare. This study aimed to explore the association between serum amyloid A (SAA) and cognitive impairment, and it also developed a nomogram for predicting the risk of PSCI in lacunar infarction patients.MethodsA total of 313 patients with lacunar infarction were enrolled in this retrospective study between January 2021 and December 2021. They were divided into a training set and a validation set at 70%:30% randomly. The Chinese version of the Mini-Mental State Examination (MMSE) was performed to identify cognitive impairment 3 months after discharge. Univariate and multivariate logistic regression analyses were used to determine the independent risk factors for PSCI in the training set. A nomogram was developed based on the five variables, and the calibration curve and the receiver operating characteristic (ROC) curve were drawn to assess the predictive ability of the nomogram between the training set and the validation set. The decision curve analysis (DCA) was also conducted in both sets.ResultsIn total, 52/313 (16.61%) participants were identified with PSCI. The SAA levels in patients with PSCI were significantly higher than non-PSCI patients in the training set (P < 0.001). After multivariate analysis, age, diabetes mellitus, white blood count, cystatin C, and SAA were independent risk predictors of PSCI. The nomogram demonstrated a good discrimination performance between the training set (AUC = 0.860) and the validation set (AUC = 0.811). The DCA showed that the nomogram had a well clinical utility in the two sets.ConclusionThe increased SAA is associated with PSCI in lacunar infarction patients, and the nomogram developed with SAA can increase prognostic information for the early detection of PSCI.

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“…The total score is utilized to assess the degree of depression of participants, with scores of ≥5 indicating depression, and scores of 5–9 mild depression; 10–14 moderate depression; 15–19 moderately severe depression; and scores of ≥20 severe depression. This instrument has been validated among various Chinese populations [ 30 , 31 ]. In this study, the Cronbach’s alpha of the instrument was 0.914.…”

Section: Methodsmentioning

confidence: 99%

Influencing factors of anxiety and depression of discharged COVID-19 patients in Wuhan, China

et al. 2022

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Objectives This study is intended to assess the prevalence of depression and anxiety in individuals who had recovered from COVID-19 and been discharged from hospital (RD hereafter) in Wuhan, China, and to explore the factors associated with these mental disorders. Methods Participants of this study were the RD who were infected at the beginning of the outbreak from 13 communities in Jianghan District of Wuhan City, Hubei Province, China by convenience sampling in mid-2021. The Generalized Anxiety Disorder Questionnaire, the Patient Health Questionnaire, the Short Version of COVID-19 Stigma Scale, the Peace of Mind Scale, the Resilience Style Questionnaire, and the Perceived Social Support Questionnaire were used to collect relevant information of the participants. Descriptive analyses, Pearson correlation analysis, and logistic regression analysis were used to describe and analyze the data and to examine the factors associated with the mental health status of this population. Results In total, we recruited 1601 participants from 3059 COVID-19 patients, and 1541 participants completed the questionnaire survey, with a response rate of 96.25%. Finally, 1297 participants met the inclusion and exclusion criteria in this study, of whom 28.8% and 37.9% reported mild to severe levels of anxiety and depression symptoms. Perceived better mental health status during hospitalization, higher frequency of alcohol use per week, peace of mind, higher education level, and resilience were negatively associated with anxiety, while stigma and history of psychological or emotional counseling before infection was positively associated with anxiety. More severe clinical classification of COVID-19 and stigma (AOR = 1.057, P<0.001) were both positively associated with depression, while perceived better mental health status during hospitalization (AOR = 0.564, P<0.001), higher frequency of alcohol use per week (AOR = 0.462, P = 0.004), peace of mind (AOR = 0.857, P<0.001), and social support (AOR = 0.972, P = 0.034) were negatively associated with depression. Conclusions Tailored interventions on reducing stigma, enhancing mindfulness and social support should be taken into account to alleviate anxiety and depression among RD.

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Functional Disability After Ischemic Stroke: A Community-Based Cross-Sectional Study in Shanghai, China

Cited by 33 publications

References 44 publications

Health outcomes after acute ischemic stroke:retrospective and survival analysis from Oman

Health outcomes after acute ischemic stroke:retrospective and survival analysis from Oman

High serum amyloid A predicts risk of cognitive impairment after lacunar infarction: Development and validation of a nomogram

Influencing factors of anxiety and depression of discharged COVID-19 patients in Wuhan, China

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