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Trends in Activities of Daily Living among Stroke Survivors:Analysis from the South London Stroke Register

机译：中风幸存者日常生活活动的趋势：来自南伦敦中风登记簿的分析

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Background National and international acute stroke care guidelines came into effect during the last decade to improve outcomes after stroke but their impact on activities of daily living (ADL) improvement over time is not known. The aim of the study was to examine post-stroke ADL trends over time in a multiethnic population in England, and to examine these trends in different socio-economic groups. Methods Data from the South London Stroke Register were analysed from 1995 to 2011. At 3 months and 1 year post-stroke, basic and instrumental ADL were measured using Barthel Index (poor outcome- BI score<15) and Frenchay Activities Index (poor outcome- FAI score<=15), respectively. Simple and multiple logistic regression analyses were performed. Results At 3 months post-stroke, the prevalence of poor basic ADL reduced significantly from 33.4% in 1995-1998 to 25.1% in 2008-2011 (trend p<0.001) and poor instrumental ADL declined significantly from 59.8% to 53.1% (trend p=0.005). The corresponding figures at 1 year were: from 27.8% to 24.3% (trend p=0.001) and from 51.6% to 42.8% (trend p=0.004). At 3 months, significant reduction in poor ADL was observed over time in the first (least deprived) and second Index of Multiple Deprivation (IMD) tertiles (trend p=0.006 and 0.001, respectively in poor basic ADL; 0.019 and 0.047, respectively in poor instrumental ADL). At 1 year, poor basic ADL declined significantly in the first and third IMD tertiles (trend p=0.002 and 0.043, respectively), whereas poor instrumental ADL reduced significantly only in the first IMD tertile (trend p=0.05). Conclusion ADL has improved over time among stroke survivors. This may reflect the effectiveness of acute stroke care. Disparities in ADL improvement still exist in different socio-economic groups, and health inequality needs to be tackled.
机译：背景技术国家和国际急性中风护理指南在过去十年中生效，以改善中风后的结局，但随着时间的推移，这些指南对日常生活活动（ADL）改善的影响尚不清楚。该研究的目的是研究英格兰多族裔人群中风后ADL随时间的变化趋势，并研究不同社会经济群体中的这些趋势。方法分析1995年至2011年南伦敦卒中登记处的数据。在卒中后3个月和1年时，使用Barthel指数（不良结局-BI评分<15）和Frenchay活动指数（不良结局）测量基础和工具性ADL -FAI分数<= 15）。进行了简单和多重逻辑回归分析。结果卒中后3个月，不良ADL的患病率从1995-1998年的33.4％显着下降至2008-2011年的25.1％（趋势p <0.001），而仪器性不良ADL的患病率从59.8％显着下降至53.1％（趋势） p = 0.005）。一年的相应数字是：从27.8％到24.3％（趋势p = 0.001）和从51.6％到42.8％（趋势p = 0.004）。在3个月时，观察到随着时间的推移，第一（最剥夺）和第二个多重剥夺指数（IMD）三分位数的不良ADL显着降低（趋势，基本不良ADL的趋势分别为p = 0.006和0.001；在较差的基本ADL中分别为0.019和0.047）不良的工具性ADL）。在第一年，IMD第一和第三位差的基本ADL显着下降（趋势p = 0.002和0.043），而仅IMD第一位的差的工具性ADL显着降低（趋势p = 0.05）。结论随着时间的流逝，卒中幸存者的ADL有所改善。这可能反映了急性中风护理的有效性。在不同的社会经济群体中，改善ADL的差异仍然存在，需要解决健康不平等问题。

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