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The Influence of Age on Functional Independence Outcome in Stroke Patients

腦中風病患之年齡對復健預後生活獨立之影響

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摘要


為分析年齡對腦中風病患復健成果的影響,林口長庚紀念醫院復健科自1995年4月至1996年3月之間收錄了201位住院的腦中風病患進行研究,並以生活功能獨立程度量度表(Functional Independence Measure, FIM)加以評估。FIM評估包括自我照顧、排便、移位、走動、溝通及社會認同等六大生活項目之依賴度。其中共可分18個小項,每項得分最高7分,最低1分,故分數自18分至126分。除了記錄病患入院、出院之FIM及其進步分數之外,並將此分數與病患年齡、性別、中風之位置(大腦左、右半球及腦幹)及中風之類型作相關性之研究。就年齡而言,病患可分為年輕組(小於40歲以下,佔6.5%),中年組(41歲-64歲,佔40.8%),及老年組(65歲以上,佔52.7%)。為比較起見,老年組的病患還進一步分為”少老組”(young old,65歲-74歲)及”耆老組”(old old,75歲以上)。 研究結果發現老年組的病患在入、出院及住院進步之FIM分數上均較其他組為低(p=0.024),但在少老組及耆老組之間並無明顯的差別。入院之FIM分數較低的病患,往往需要較長的住院日數(p=0.029)。中年組的腦中風病患,其住院日數較其他組為短。而在老年組的病患中,少老組與耆老組之住院日數並無明顯的差異。此外,中風病患的性別、中風位置及中風的類型並不是影響其住院日數長短的因素。女性中風病患的年齡明顯地比男性高,但就FIM分數而言,男女在入、出院及進步分數上並未達統計學上有明顯的差異。由本研究得知,老年的腦中風病患在急性期復健過程中,有較嚴重的初始功能損失以及較差的復健預後。

關鍵字

腦中風 年齡 功能獨立量表

並列摘要


Two hundred and one stroke patients who were admitted to the Rehabilitation Department of Chang Gung Memorial Hospital, Linkou, from April 1995 to March 1996 were evaluated by the Functional Independence Measure (FIM) in order to analyze the influence of age on stroke outcome. FIM scores on admission and discharge and the gain of FIM Two hundred and one stroke patients who were admitted to the Rehabilitation Department of Chang Gung Memorial Hospital, Linkou, from April 1995 to March 1996 were evaluated by the Functional Independence Measure (FIM) in order to analyze the influence of age on stroke outcome. FIM scores on admission and discharge and the gain of FIM scores were recorded in correlation with age, gender, lesion side and type of stroke. Patients were divided into young stroke (< 40 years, 6.5%), middle age stroke (40-64 years, 40.8%) and geriatric group ( 65 years, 52.7%). The geriatric group was also divided into young old (65-74 years) and old old ( 75 years or older) for comparison. The FIM scores were lowest in the geriatric group on admission, discharge and gain during hospitalization (p=0.024), but there was no significant difference between the young old and old old groups. The patients with lower FIM scores on admission required a longer hospital stay (p=0.029). The middle age group had a shorter stay than other groups. In the geriatric group, there was no significant difference in hospital stay between the young old and old old. Gender, side of lesion, and type of stroke were not influencing factors for longer hospital stays. Female stroke patients were significantly older on the average than male, but there were no significant differences in FIM scores on admission, discharge or gain. In conclusion, geriatric stroke patients had more severe initial disability and less recovery than younger patients after acute rehabilitation.

並列關鍵字

stroke age functional independence measure FIM

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