Avtor/Urednik		Bavec, Andrej; Plaskan, Lidija
Naslov		Spol in funkcijski izid trombolitičnega zdravljenja akutne ishemične možganske kapi v Splošni bolnišnici Celje
Prevedeni naslov		Sex-differences and functional outcome in acute ischaemic stroke after thrombolysis in the Celje general hospital
Tip		članek
Vol. in št.		Letnik 17, št. 1
Leto izdaje		2018
Obseg		str. 12-18
ISSN		1580-9315 - Rehabilitacija
Jezik		slv
Abstrakt		Izhodišča: Raziskave, ki proučujejo razlike med spoloma in njihov vpliv na funkcijski izid po trombolitičnem zdravljenju ishemične možganske kapi (IMK), imajo različne, tudi nasprotujoče si rezultate. Namen raziskave je bil proučiti klinične značilnosti in funkcijski izid oseb po IMK glede na spol. Metode: V retrospektivno raziskavo je bilo vključenih vseh 141 bolnikov, ki so bili zaradi akutne IMK zdravljeni s trombolizo v Splošni bolnišnici Celje od 1. 2. 2012 do 31.12. 2014. Podatke za analizo smo zbrali iz medicinske dokumentacije. Izključitveno merilo je bilo naknadno zdravljenje z mehansko revaskularizacijo (n=7). Za oceno razlik med spoloma smo uporabili test t in hi-kvadrat test. Funkcijski izid trombolitičnega zdravljenja smo ocenili z modificirano Rankinovo lestvico (mRS) in ga podali kot razmerje obetov. Rezultati: Delež žensk je bil 42 %, bile so starejše kot moški (povprečna razlika 9,3 leta, 95 % interval zaupanja (IZ) 5,3 % 13,3 let, p<0,001) in s hujšo stopnjo nevrološke okvare, ocenjeno z lestvico NIHSS za povprečno 3,0 točke (IZ od 0,9 do 5,0; p=0,006). Med vaskularnimi dejavniki tveganja za slab izid sta bili pri ženskah pogostejši arterijska hipertenzija (p=0,019) in atrijska fibrilacija (p=0,018). Ocenjeno razmerje obetov za slab funkcijski izid (ocena mRS 3-6) žensk v primerjavi z moškimi je bilo ob odpustu iz bolnišnice 2,5 (IZ 1,2- 5,2, p=0,017), ob kontrolnem pregledu pa 1,0 (IZ 0,3-3,2, p=0,930). Zaključki: Ženske so v večji meri zastopane v višjih starostnih skupinah, v katerih so možganska kap in pridružene bolezni pogostejše, ter ob tem utrpijo obsežnejše nevrološke okvare kot moški. To je lahko povezano s funkcijskim izidom po trombolitičnem zdravljenju.Background: Several studies investigating the relation between sex and functional outcome after thrombolysis in ischaemic stroke patients show conflicting results. The aim of our study was to assess sex-differences in clinical characteristics and functional outcome in this population. Methods: Our retrospective study included all 141 ischaemic stroke patients treated with thrombolysis at the Celje General Hospital between 1 February 2012 and 31 December 2014. The data were obtained from medical records. The patients who were later treated with mechanical revascularization were excluded (n = 7). Statistical comparisons between women and men were done using t-test and chi-squared test. Functional outcome was measured with modified Rankin scale (mRS). Odds ratio for poor functional outcome was estimated using multiple logistic regression. Results: Forty-two per cent of patients were women; they were older than men on average (mean difference 9.3 years, 95 % confidence interval (CI) 5.3 % 13.3 years, p<0.001) and suffered more severe stroke on average as measured with the NIHSS scale (mean difference 3.0 points, CI 0.9 % 5.0, p=0,006). Among vascular risk factors for poor outcome, arterial hypertension (p = 0.019) and atrial fibrillation (p = 0.018) were more common in women. The estimated odds ratio for poor functional outcome (mRS score 3-6) in women as compared to men was 2.5 (CI 1.2-5.2, p = 0.017) at discharge and 1.0 (CI 0.3-3.2, p = 0.930) at follow-up. Conclusions: Women are overrepresented in higher age groups in which stroke is more common and comorbidities more frequent. This could be related to severity of neurological impairment in stroke and potentially influence functional outcome after thrombolytic treatment.
Deskriptorji		Stroke therapy
Proste vsebinske oznake		stroke rehabilitation thrombolytic therapy female age distribution time to treatment možganska kap rehabilitacija trombolitična terapija ženske starostna porazdelitev čas do zdravljenja