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Zhou J, Liu F, Zhou M, Long J, Zha F, Chen M, Li J, Yang Q, Zhang Z, Wang Y. Functional status and its related factors among stroke survivors in rehabilitation departments of hospitals in Shenzhen, China: a cross-sectional study. BMC Neurol 2022; 22:173. [PMID: 35546388 PMCID: PMC9092870 DOI: 10.1186/s12883-022-02696-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 04/22/2022] [Indexed: 11/23/2022] Open
Abstract
Background Many stroke survivors have multiple chronic diseases and complications coupled with various other factors which may affect their functional status. We aimed to investigate the factors associated with poor functional status in hospitalized patients with stroke in Shenzhen, China. Methods In this cross-sectional study, four urban hospitals were selected using convenient sampling, and all stroke patients in these four hospitals were included using cluster sampling. The functional status of stroke survivors was evaluated using Longshi Scale. Explanatory variables (factors affecting functional status comprising age, sex, body mass index, smoking, alcohol consumption, complications, and chronic conditions) were collected. Ordinal logistic regression was used to examine which factors were associated with poor functional status. Results Stroke survivors with poor functional status accounted for 72.14% and were categorised as the bedridden group based on Longshi scale, 21.67% of patients with moderate functional limitation were categorised as the domestic group, and 6.19% of the patients with mild functional restriction were categorised as the community group. The highest dependence scores were noted for feeding (73.39%), bowel and bladder management (69.74%) and entertainment (69.53%) among the bedridden group, and housework (74.29%) among the domestic group. In the adjusted model, the odds of poor functional status were higher among stroke patients with older age (odds ratio [OR] = 2.39, 95% CI: 1.55–3.80), female sex (OR = 1.73, 95% CI: 1.08–2.77), duration of stroke more than 12 months (OR = 1.94, 95% CI: 1.28–2.95), with pulmonary infection (OR = 10.91, 95% CI: 5.81–20.50), and with deep venous thrombosis (OR = 3.00, 95% CI: 1.28–7.04). Conclusions Older adults (age ≥ 60 years) and women were more likely to exhibit poor functional status post-stroke. Pulmonary infection and deep venous thrombosis were related to an increased risk of being dependent on activities of daily living. Therefore, clinical and rehabilitation interventions aimed at preventing or treating these common complications should be addressed to deal with subsequent dysfunction post-stroke. Since all data were obtained in metropolitan areas where the economy is well developed, future studies should be conducted in rural areas and economically less developed cities. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-022-02696-0.
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Affiliation(s)
- Jing Zhou
- Department of Rehabilitation, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Guangdong Province, 3002 Sungang West Road, Futian District, Shenzhen, 518035, China
| | - Fang Liu
- Department of Rehabilitation, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Guangdong Province, 3002 Sungang West Road, Futian District, Shenzhen, 518035, China
| | - Mingchao Zhou
- Department of Rehabilitation, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Guangdong Province, 3002 Sungang West Road, Futian District, Shenzhen, 518035, China
| | - Jianjun Long
- Department of Rehabilitation, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Guangdong Province, 3002 Sungang West Road, Futian District, Shenzhen, 518035, China
| | - Fubing Zha
- Department of Rehabilitation, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Guangdong Province, 3002 Sungang West Road, Futian District, Shenzhen, 518035, China
| | - Miaoling Chen
- Department of Rehabilitation, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Guangdong Province, 3002 Sungang West Road, Futian District, Shenzhen, 518035, China
| | - Jiehui Li
- Shandong University of Traditional Chinese Medicine, Shandong Province, 4655 Daxue Road, Changqing District, Jinan, 250355, China
| | - Qingqing Yang
- Shandong University of Traditional Chinese Medicine, Shandong Province, 4655 Daxue Road, Changqing District, Jinan, 250355, China
| | - Zeyu Zhang
- Shandong University of Traditional Chinese Medicine, Shandong Province, 4655 Daxue Road, Changqing District, Jinan, 250355, China
| | - Yulong Wang
- Department of Rehabilitation, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, Guangdong Province, 3002 Sungang West Road, Futian District, Shenzhen, 518035, China.
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Polivka J, Polivka J, Pesta M, Rohan V, Celedova L, Mahajani S, Topolcan O, Golubnitschaja O. Risks associated with the stroke predisposition at young age: facts and hypotheses in light of individualized predictive and preventive approach. EPMA J 2019; 10:81-99. [PMID: 30984317 DOI: 10.1007/s13167-019-00162-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 02/06/2019] [Indexed: 12/25/2022]
Abstract
Stroke is one of the most devastating pathologies of the early twenty-first century demonstrating 1-month case-fatality rates ranging from 13 to 35% worldwide. Though the majority of cases do occur in individuals at an advanced age, a persistently increasing portion of the patient cohorts is affected early in life. Current studies provide alarming statistics for the incidence of "young" strokes including adolescents. Young stroke is a multifactorial disease involving genetic predisposition but also a number of modifiable factors, the synergic combination of which potentiates the risks. The article analyzes the prevalence and impacts of "traditional" risk factors such as sedentary lifestyle, smoking, abnormal alcohol consumption, drug abuse, overweight, hypertension, abnormal sleep patterns, and usage of hormonal contraceptives, among others. Further, less explored risks such as primary vascular dysregulation and associated symptoms characteristic for Flammer syndrome (FS) are considered, and the relevance of the FS phenotype for the stroke predisposition at young age is hypothesized. Considering the high prevalence of known genetic and modifiable risk factors in the overall predisposition to the young stroke, the risk mitigating measures are recommended including innovative screening programs by application of specialized questionnaires and biomarker panels as well as educational programs adapted to the target audiences such as children, adolescents, and young adults.
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Affiliation(s)
- Jiri Polivka
- 1Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
- 2Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
- 3Department of Neurology, University Hospital Pilsen, and Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
| | - Jiri Polivka
- 3Department of Neurology, University Hospital Pilsen, and Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
| | - Martin Pesta
- 2Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
- 4Department of Biology, Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
| | - Vladimir Rohan
- 3Department of Neurology, University Hospital Pilsen, and Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
| | - Libuse Celedova
- 5Department of Social and Assessment Medicine, Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
| | | | - Ondrej Topolcan
- 7Department of Immunochemistry, University Hospital Pilsen, Pilsen, Czech Republic
| | - Olga Golubnitschaja
- 8Radiological Clinic, UKB, Rheinische Friedrich-Wilhelms-Universität Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
- 9Breast Cancer Research Centre, UKB, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
- 10Centre for Integrated Oncology, Cologne-Bonn, UKB, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
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