临床衰弱对老年缺血性脑卒中患者短期预后的预测价值  

Predictive value of clinical frailty for short-term prognosis in elderly patients with ischemic stroke

作　　者：王秋 徐琴 WANG Qiu;XU Qin(Anhui NO.2 Provincial People’s Hospital,Hefei 230041,China;Huainan Sunshine Xinkang Hospital,Huainan 232000,China)

机构地区：[1]安徽省第二人民医院,安徽合肥230041 [2]淮南市阳光新康医院,安徽淮南232000

出　　处：《中国实用神经疾病杂志》2025年第4期492-496,共5页Chinese Journal of Practical Nervous Diseases

基　　金：安徽中医药大学科研基金项目(编号:2023LCTH44)。

摘　　要：目的探讨临床衰弱对老年缺血性脑卒中患者短期预后的预测价值。方法选取2021-02—2023-02安徽省第二人民医院的老年缺血性脑卒中患者102例,采用改良Rankin量表(mRS)评价患者3个月的预后情况,分为预后不良组、预后良好组。比较2组患者的基线资料、实验室资料、治疗情况及卒中前临床衰弱评分(CFS)。采用Logistic多因素回归分析老年缺血性脑卒中患者预后不良的影响因素,绘制受试者工作特征(ROC)曲线分析卒中前CFS评分对缺血性脑卒中患者预后不良的预测价值,依据ROC截断值与临床衰弱评估标准将患者分组,再次验证CFS评分对患者预后的影响。结果Logistic多因素回归分析显示,年龄(OR=1.140)、NIHSS评分(OR=1.323)、梗死面积(OR=2.379)、超敏C反应蛋白水平(OR=1.208)、CFS评分(OR=1.539)均为老年缺血性脑卒中患者预后不良的重要影响因素(P<0.05)。ROC曲线分析显示,采用卒中前CFS评分预测缺血性脑卒中患者预后不良的AUC为0.848,敏感度80.95%,特异度85.19%。卒中前高CFS评分(≥5.535分)患者3个月预后不良率高于低CFS评分(<5.535分)患者(P<0.05)。结论临床衰弱对老年缺血性脑卒中患者短期预后具有良好的预测价值,可对预后预测提供一定指导。Objective To investigate the predictive value of clinical frailty for short-term prognosis in elderly patients with ischemic stroke.Methods A total of 102 elderly patients with ischemic stroke admitted to Anhui NO.2 Provincial People’s Hospital from February 2021 to February 2023 were selected.The modified Rankin scale(mRS)was used to evaluate patients’prognosis at three-month,and they were dividing into poor prognosis group and good prognosis group.Baseline characteristics,laboratory data,treatment conditions,and pre-stroke clinical frailty scale(CFS)scores were compared between the two groups.Multivariate Logistic regression analysis was performed to investigate the factors affecting poor prognosis in elderly ischemic stroke patients.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of pre-stroke CFS scores for poor prognosis.Patients were regrouped based on ROC cut-off values and clinical frailty assessment criteria to further verify the impact of CFS scores on prognosis.Results Multivariate Logistic regression analysis showed that age(OR=1.140),NIHSS score(OR=1.323),infarction area(OR=2.379),high-sensitivity C-reactive protein level(OR=1.208),and CFS score(OR=1.539)were significant factors affecting poor prognosis in elderly ischemic stroke patients(P<0.05).The ROC curve analysis revealed that pre-stroke CFS score had the area under the curve(AUC)of 0.848 for predicting poor prognosis,with sensitivity of 80.95%and specificity of 85.19%.Patients with high pre-stroke CFS scores(≥5.535)showed a higher three-month poor prognosis rate compared to those with low CFS scores(<5.535,P<0.05).Conclusion Clinical frailty demonstrates good predictive value for short-term prognosis in elderly patients with ischemic stroke and can provide guidance for prognostic prediction.

关 键 词：缺血性脑卒中 临床衰弱 短期预后 预后不良 影响因素 老年 预测价值 

分 类 号：R743.3[医药卫生—神经病学与精神病学]