A cohort study of the effects of dementia and dependence on the three-month outcome of acute stroke / 中国实用护理杂志

ABSTRACT

Objective@#To investigate the effect of pre-stroke dependence and pre-stroke combined dementia on the outcome of 3 months after stroke in patients aged more than 65 years.@*Methods@#This study was a retrospective cohort study. A total of 966 patients with acute stroke were enrolled in the Department of Neurology, the First Affiliated Hospital of China Medical University from March 2015 to March 2018, including 168 patients diagnosed with dementia before acute stroke for the dementia group, and the remaining 798 people were treated as the non-dementia group. The demographic differences between the two groups at admission were compared. With the death and independence as the dependent variable within 3 months after the diagnosis of acute stroke, the independent risk of admission and the presence of dementia were used as covariates to make a COX proportional hazard assessment.@*Results@#There was significant difference in the number of medications, consistently taken with warfarin, pre-stroke independence, admission status between the dementia group and the non-dementia group (U=3.42, χ2=4.52, 8.96, 8.76, P<0.01). There was no significant difference in the number of deaths between the two groups during admission (χ2=0.96, P>0.05). There was significant difference in the number of deaths within 3 months after discharge and dependence within 3 months after stroke between the two groups (χ2=5.69, 6.94, P < 0.01). Patients with pre-stroke dementia died during hospitalization and died within 3 months after discharge, the risk of moderate-to-severe dependence within 3 months after discharge was 1.00, 1.32, 2.56 compared with those who were completely independent before admission; mild dependence before admission patients who died before the stroke were completely dead during hospitalization and died within 3 months after discharge, the risk of moderate-to-severe dependence within 3 months after discharge was 1.42, 1.86, 2.73, respectively. Patients who were moderately dependent before admission were more likely to die from hospitalization than those who were completely independent before stroke, the risk of death within 3 months after discharge was 1.68, 2.42, respectively. Patients who were heavily dependent before admission were more likely to die from hospitalization than those who were completely independent before stroke, the risk of death within 3 months after discharge was 1.89, 3.24, respectively.@*Conclusions@#Pre-stroke dementia and activity disorder lead to a high risk of death and high disability within 3 months after stroke.