Estimates of the prevalence of acute stroke impairments and disability in a multiethnic population
The goals of the present study were to estimate the prevalence of acute impairments and disability in a multiethnic population of first-ever stroke and to identify differences in impairment and early disability between pathological and Bamford subtypes. Associations between impairments and death and...
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| Veröffentlicht in: | Stroke (1970) 2001-06, Vol.32 (6), p.1279-1284 |
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| container_title | Stroke (1970) |
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| creator | LAWRENCE, Enas S COSHALL, Catherine DUNDAS, Ruth STEWART, Judy RUDD, Anthony G HOWARD, Robin WOLFE, Charles D. A |
| description | The goals of the present study were to estimate the prevalence of acute impairments and disability in a multiethnic population of first-ever stroke and to identify differences in impairment and early disability between pathological and Bamford subtypes. Associations between impairments and death and disability at 3 months were identified.
Impairments that occur at the time of maximum neurological deficit were recorded, and disability according to the Barthel Index (BI) was assessed 1 week and 3 months after stroke in patients in the South London Stroke Register:
Of 1259 registered patients, 6% had 1 or 2, 31.1% had 3 to 5, 50.6% had 6 to 10, and 10.6% had >10 impairments. Common impairments were weakness (upper limb, 77.4%), urinary incontinence (48.2%), impaired consciousness (44.7%), dysphagia (44.7%), and impaired cognition (43.9%). Patients with total anterior circulation infarcts had the highest age-adjusted prevalence of weakness, dysphagia, urinary incontinence, cognitive impairment, and disability. Patients with subarachnoid hemorrhage had the highest rates of coma. Patients with lacunar stroke had the high prevalence of weakness but were least affected by disability, incontinence, and cognitive dysfunction. Blacks had higher age- and sex-adjusted rates of disability in ischemic stroke (BI |
| doi_str_mv | 10.1161/01.str.32.6.1279 |
| format | Article |
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Impairments that occur at the time of maximum neurological deficit were recorded, and disability according to the Barthel Index (BI) was assessed 1 week and 3 months after stroke in patients in the South London Stroke Register:
Of 1259 registered patients, 6% had 1 or 2, 31.1% had 3 to 5, 50.6% had 6 to 10, and 10.6% had >10 impairments. Common impairments were weakness (upper limb, 77.4%), urinary incontinence (48.2%), impaired consciousness (44.7%), dysphagia (44.7%), and impaired cognition (43.9%). Patients with total anterior circulation infarcts had the highest age-adjusted prevalence of weakness, dysphagia, urinary incontinence, cognitive impairment, and disability. Patients with subarachnoid hemorrhage had the highest rates of coma. Patients with lacunar stroke had the high prevalence of weakness but were least affected by disability, incontinence, and cognitive dysfunction. Blacks had higher age- and sex-adjusted rates of disability in ischemic stroke (BI <20, odds ratio 2.76, 95% CI 1.47 to 5.21, P=0.002; BI <15, odds ratio 1.8, 95% CI 1.45 to 2.81, P=0.01) but impairment rates similar to those of whites. On multivariable analysis, incontinence, coma, dysphagia, cognitive impairment, and gaze paresis were independently associated with severe disability (BI <10) and death at 3 months.
The extent of these findings indicates that an acute assessment of impairments and disability is necessary to determine the appropriate nursing and rehabilitation needs of patients with stroke.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/01.str.32.6.1279</identifier><identifier>PMID: 11387487</identifier><identifier>CODEN: SJCCA7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>African Continental Ancestry Group ; Age Distribution ; Aged ; Biological and medical sciences ; Cognition Disorders - diagnosis ; Cognition Disorders - epidemiology ; Comorbidity ; Demography ; Disability Evaluation ; European Continental Ancestry Group ; Female ; Glasgow Coma Scale ; Humans ; Incidence ; Logistic Models ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Middle Aged ; Neurology ; Odds Ratio ; Population Surveillance ; Prevalence ; Registries - statistics & numerical data ; Severity of Illness Index ; Sex Distribution ; Stroke - diagnosis ; Stroke - epidemiology ; Stroke - ethnology ; Stroke - mortality ; Tomography, X-Ray Computed ; Urban Population ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Stroke (1970), 2001-06, Vol.32 (6), p.1279-1284</ispartof><rights>2001 INIST-CNRS</rights><rights>Copyright American Heart Association, Inc. Jun 2001</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c606t-c074d41ca2f0445ceecacd86b92b51268f2d546653a13c804d8da16ef7ffc6103</citedby><cites>FETCH-LOGICAL-c606t-c074d41ca2f0445ceecacd86b92b51268f2d546653a13c804d8da16ef7ffc6103</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1002603$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11387487$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>LAWRENCE, Enas S</creatorcontrib><creatorcontrib>COSHALL, Catherine</creatorcontrib><creatorcontrib>DUNDAS, Ruth</creatorcontrib><creatorcontrib>STEWART, Judy</creatorcontrib><creatorcontrib>RUDD, Anthony G</creatorcontrib><creatorcontrib>HOWARD, Robin</creatorcontrib><creatorcontrib>WOLFE, Charles D. A</creatorcontrib><title>Estimates of the prevalence of acute stroke impairments and disability in a multiethnic population</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>The goals of the present study were to estimate the prevalence of acute impairments and disability in a multiethnic population of first-ever stroke and to identify differences in impairment and early disability between pathological and Bamford subtypes. Associations between impairments and death and disability at 3 months were identified.
Impairments that occur at the time of maximum neurological deficit were recorded, and disability according to the Barthel Index (BI) was assessed 1 week and 3 months after stroke in patients in the South London Stroke Register:
Of 1259 registered patients, 6% had 1 or 2, 31.1% had 3 to 5, 50.6% had 6 to 10, and 10.6% had >10 impairments. Common impairments were weakness (upper limb, 77.4%), urinary incontinence (48.2%), impaired consciousness (44.7%), dysphagia (44.7%), and impaired cognition (43.9%). Patients with total anterior circulation infarcts had the highest age-adjusted prevalence of weakness, dysphagia, urinary incontinence, cognitive impairment, and disability. Patients with subarachnoid hemorrhage had the highest rates of coma. Patients with lacunar stroke had the high prevalence of weakness but were least affected by disability, incontinence, and cognitive dysfunction. Blacks had higher age- and sex-adjusted rates of disability in ischemic stroke (BI <20, odds ratio 2.76, 95% CI 1.47 to 5.21, P=0.002; BI <15, odds ratio 1.8, 95% CI 1.45 to 2.81, P=0.01) but impairment rates similar to those of whites. On multivariable analysis, incontinence, coma, dysphagia, cognitive impairment, and gaze paresis were independently associated with severe disability (BI <10) and death at 3 months.
The extent of these findings indicates that an acute assessment of impairments and disability is necessary to determine the appropriate nursing and rehabilitation needs of patients with stroke.</description><subject>African Continental Ancestry Group</subject><subject>Age Distribution</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cognition Disorders - diagnosis</subject><subject>Cognition Disorders - epidemiology</subject><subject>Comorbidity</subject><subject>Demography</subject><subject>Disability Evaluation</subject><subject>European Continental Ancestry Group</subject><subject>Female</subject><subject>Glasgow Coma Scale</subject><subject>Humans</subject><subject>Incidence</subject><subject>Logistic Models</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Odds Ratio</subject><subject>Population Surveillance</subject><subject>Prevalence</subject><subject>Registries - statistics & numerical data</subject><subject>Severity of Illness Index</subject><subject>Sex Distribution</subject><subject>Stroke - diagnosis</subject><subject>Stroke - epidemiology</subject><subject>Stroke - ethnology</subject><subject>Stroke - mortality</subject><subject>Tomography, X-Ray Computed</subject><subject>Urban Population</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0U2L1TAUBuAginMd3buSIKKr1nOSNE2XMowfMCDouA5pmjAZ27QmqTD_3lzmguJCV4HwnDcfLyHPEVpEiW8B21xSy1krW2T98IAcsGOiEZKph-QAwIeGiWE4I09yvgUAxlX3mJwhctUL1R_IeJlLWExxma6elhtHt-R-mtlF6447xu7F0XrI-t3RsGwmpMXFkqmJE51CNmOYQ7mjIVJDl30uwZWbGCzd1m2fTQlrfEoeeTNn9-y0npNv7y-vLz42V58_fLp4d9VYCbI0FnoxCbSGeRCis85ZYyclx4GNHTKpPJs6IWXHDXKrQExqMiid7723EoGfkzf3uVtaf-wuF72EbN08m-jWPeu-xw5QCfZ_KQUyxRhW-frfEtSAqHiFL_-Ct-ueYn2vxqFX9f5CVAT3yKY15-S83lL9_HSnEfSxUA2ov15_0ZxpqY-F1pEXp9x9XNz0e-DUYAWvTsBka2afTLQh_xEMTALnvwAbeajZ</recordid><startdate>20010601</startdate><enddate>20010601</enddate><creator>LAWRENCE, Enas S</creator><creator>COSHALL, Catherine</creator><creator>DUNDAS, Ruth</creator><creator>STEWART, Judy</creator><creator>RUDD, Anthony G</creator><creator>HOWARD, Robin</creator><creator>WOLFE, Charles D. 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A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c606t-c074d41ca2f0445ceecacd86b92b51268f2d546653a13c804d8da16ef7ffc6103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>African Continental Ancestry Group</topic><topic>Age Distribution</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cognition Disorders - diagnosis</topic><topic>Cognition Disorders - epidemiology</topic><topic>Comorbidity</topic><topic>Demography</topic><topic>Disability Evaluation</topic><topic>European Continental Ancestry Group</topic><topic>Female</topic><topic>Glasgow Coma Scale</topic><topic>Humans</topic><topic>Incidence</topic><topic>Logistic Models</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Odds Ratio</topic><topic>Population Surveillance</topic><topic>Prevalence</topic><topic>Registries - statistics & numerical data</topic><topic>Severity of Illness Index</topic><topic>Sex Distribution</topic><topic>Stroke - diagnosis</topic><topic>Stroke - epidemiology</topic><topic>Stroke - ethnology</topic><topic>Stroke - mortality</topic><topic>Tomography, X-Ray Computed</topic><topic>Urban Population</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>LAWRENCE, Enas S</creatorcontrib><creatorcontrib>COSHALL, Catherine</creatorcontrib><creatorcontrib>DUNDAS, Ruth</creatorcontrib><creatorcontrib>STEWART, Judy</creatorcontrib><creatorcontrib>RUDD, Anthony G</creatorcontrib><creatorcontrib>HOWARD, Robin</creatorcontrib><creatorcontrib>WOLFE, Charles D. 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A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Estimates of the prevalence of acute stroke impairments and disability in a multiethnic population</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2001-06-01</date><risdate>2001</risdate><volume>32</volume><issue>6</issue><spage>1279</spage><epage>1284</epage><pages>1279-1284</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><coden>SJCCA7</coden><abstract>The goals of the present study were to estimate the prevalence of acute impairments and disability in a multiethnic population of first-ever stroke and to identify differences in impairment and early disability between pathological and Bamford subtypes. Associations between impairments and death and disability at 3 months were identified.
Impairments that occur at the time of maximum neurological deficit were recorded, and disability according to the Barthel Index (BI) was assessed 1 week and 3 months after stroke in patients in the South London Stroke Register:
Of 1259 registered patients, 6% had 1 or 2, 31.1% had 3 to 5, 50.6% had 6 to 10, and 10.6% had >10 impairments. Common impairments were weakness (upper limb, 77.4%), urinary incontinence (48.2%), impaired consciousness (44.7%), dysphagia (44.7%), and impaired cognition (43.9%). Patients with total anterior circulation infarcts had the highest age-adjusted prevalence of weakness, dysphagia, urinary incontinence, cognitive impairment, and disability. Patients with subarachnoid hemorrhage had the highest rates of coma. Patients with lacunar stroke had the high prevalence of weakness but were least affected by disability, incontinence, and cognitive dysfunction. Blacks had higher age- and sex-adjusted rates of disability in ischemic stroke (BI <20, odds ratio 2.76, 95% CI 1.47 to 5.21, P=0.002; BI <15, odds ratio 1.8, 95% CI 1.45 to 2.81, P=0.01) but impairment rates similar to those of whites. On multivariable analysis, incontinence, coma, dysphagia, cognitive impairment, and gaze paresis were independently associated with severe disability (BI <10) and death at 3 months.
The extent of these findings indicates that an acute assessment of impairments and disability is necessary to determine the appropriate nursing and rehabilitation needs of patients with stroke.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>11387487</pmid><doi>10.1161/01.str.32.6.1279</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Alma/SFX Local Collection; EZB Electronic Journals Library; American Heart Association; Journals@Ovid Complete |
| subjects | African Continental Ancestry Group Age Distribution Aged Biological and medical sciences Cognition Disorders - diagnosis Cognition Disorders - epidemiology Comorbidity Demography Disability Evaluation European Continental Ancestry Group Female Glasgow Coma Scale Humans Incidence Logistic Models Magnetic Resonance Imaging Male Medical sciences Middle Aged Neurology Odds Ratio Population Surveillance Prevalence Registries - statistics & numerical data Severity of Illness Index Sex Distribution Stroke - diagnosis Stroke - epidemiology Stroke - ethnology Stroke - mortality Tomography, X-Ray Computed Urban Population Vascular diseases and vascular malformations of the nervous system |
| title | Estimates of the prevalence of acute stroke impairments and disability in a multiethnic population |
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