Résumé
【Objective】 To construct and validate a risk prediction model for cognitive impairment after stroke based on demographic, clinical, and neuroimaging characteristics. 【Methods】 Through the medical record system, we collected all data of the patients. We finished cognitive function testing three months after the indexed stroke. The Mini-Mental State Examination Scale score≤26 was defined as cognitive dysfunction. Optimal subset regression analysis was used to screen variables, Logistic regression analysis was used to construct a predictive model for cognitive impairment, and C-index, calibration chart and clinical decision curve analyses were used to evaluate the discrimination, consistency, and clinical availability of the model. And nomograms were used to express the performance of the model. 【Results】 Seven variables were selected: cognitive function before stroke, age, years of education, National Institutes of Health Stroke Scale score at admission, history of ischemic heart disease, the number of old lacunar infarct lesions, and medial temporal lobe atrophy scale. The prediction model had a C-index of 0.845 (95% CI: 0.805-0.885). The clinical decision curve showed that the model had a positive net benefit when the threshold probability was 9.0%-90.0%. 【Conclusion】 The predictive model of cognitive impairment in stroke patients has good predictive efficiency and provides an effective assessment tool for screening high-risk cases of cognitive impairment in patients with stroke of various subtypes.
Résumé
Objective To study the effect of clinical nursing path(CNP)on the swallowing training of stroke patients with neural deglutition disorders.Methods Sixty stroke patients with neural deglutition disorders were recruited from January 2012 to October 2012 in the department of neurology of our hospital.The patients were divided into two groups according to the sequence of admission:the experiment group(n=30)and the control group(n=30).CNP was applied in the experimental group and the traditional nursing approach in the control.The two groups were compared in terms of the improvement of deglutition disorder.Result The effective rate of the experiment group was significantly higher than the rate of the control group(P<0.05).Conclusion CNP is effective in improving stroke patients’neural deglutition disorders and enhancing their life quality.