CAJ | 학술논문

目的：探索急性缺血性脑卒中病人住院天数与出院不良结局的关系。方法从承德医学院附属医院病案室抽取神经内科2009年5月31日至2013年5月31日所有符合纳入标准的3334病例，对病例资料采用回顾性队列研究的方法，分析急性缺血性脑卒中病患者结局良好组和结局不良组（ MRs）脑卒中量表对所有研究对象进行评分，0分≤MRs≤2分为结局良好组，3分≤MRs≤6分为结局不良组的入院时基线，并分析住院天数对急性缺血性脑卒中出院不良结局的差异。结果出院不良结局与结局良好的两组患者间入院基线在年龄、性别、住院天数、是否存在心房颤动及血糖水平等方面差异有统计学意义（ p＜0．05）；对住院天数与发生不良结局进行单因素非条件Logistic回归分析，住院时间为7～14d和14～21d的患者不良结局的出现与住院天数小于7d的患者比较，OR值分别为0．306和0．561，95％CI分别为0．239／0．391和0．434／0．726，两组P值＜0．00。多因素非条件Logistic回归分析提示，住院天数为7～14d的不良结局患者与住院时间小于7d的出院不良结局患者差异有统计学意义。结论急性缺血性脑卒中患者结局良好与结局不良组入院基线有差别，住院时间在7～14d为出院不良结局的保护性因素，合理控制住院时间，有助于患者康复治疗，减轻经济负担。
목적：탐색급성결혈성뇌졸중병인주원천수여출원불량결국적관계。방법종승덕의학원부속의원병안실추취신경내과2009년5월31일지2013년5월31일소유부합납입표준적3334병례，대병례자료채용회고성대렬연구적방법，분석급성결혈성뇌졸중병환자결국량호조화결국불량조（ MRs）뇌졸중량표대소유연구대상진행평분，0분≤MRs≤2분위결국량호조，3분≤MRs≤6분위결국불량조적입원시기선，병분석주원천수대급성결혈성뇌졸중출원불량결국적차이。결과출원불량결국여결국량호적량조환자간입원기선재년령、성별、주원천수、시부존재심방전동급혈당수평등방면차이유통계학의의（ p＜0．05）；대주원천수여발생불량결국진행단인소비조건Logistic회귀분석，주원시간위7～14d화14～21d적환자불량결국적출현여주원천수소우7d적환자비교，OR치분별위0．306화0．561，95％CI분별위0．239／0．391화0．434／0．726，량조P치＜0．00。다인소비조건Logistic회귀분석제시，주원천수위7～14d적불량결국환자여주원시간소우7d적출원불량결국환자차이유통계학의의。결론급성결혈성뇌졸중환자결국량호여결국불량조입원기선유차별，주원시간재7～14d위출원불량결국적보호성인소，합리공제주원시간，유조우환자강복치료，감경경제부담。
ObjectiveToexploretherelationshipbetweenthelengthofstayandadverseclinicaloutcome among patients with acute ischemic stroke .Methods To extract 3334 medical records from May 31, 2009 to May 31, 2013 in neural internal medicine in accord with our investigative need from Chengde Medical College Affiliated Hospital medical records room .The records used a retrospective cohort study to analyze the baseline admission patients with acute ischemic stroke between the favorable clinical outcome group and the adverse clinical outcome group.( MRs) Stroke Scale Score for all subjects , 0≤MRs≤2 into a favorable clinical outcome group , 3≤MRs≤6 into adverse clinical outcome group .and also analyze the relationship between the length of stay and adverse clinical outcome among patients with acute ischemic stroke .Rseults Compared the adverse clinical outcomes group to the favorable clinical outcomes group who were hospitalized with acute ischemic stroke , at baseline in age, gender, length of stay, the existence of atrial fibrillation and blood glucose levels and so on had statistical significance (p<0.05). From result of single factor unconditioned Logistic regression analysis , compared with the patients whose length of stay for 7 to 14 days and 14 to 21 days of the occurrence of adverse outcomes with and hospitalization days of patients less than seven days, the OR value were 0.306 and 0.306, 95%CI of 0.239/0.391 and 0.434/0.726.respectively, two groups of P<0.05.Hospitalization days and the bad result of multi-factor unconditioned Logistic regression analysis , hospitalization days for 7 to 14 days of adverse outcomes of patients and hospital stay was less than 7 days out of the hospital the occurrence of adverse outcome difference was statistically significant .Conclusion Acute ischemic stroke patients have a good outcome and poor outcome group differences in baseline hospitalization , length of stay in the hospital for 7 to14 days appear statistically significant adverse outcomes , appropriate to reduce the number of days of hospitalization may benefit of the patients recovery and may reduce the financial burden of patients .