Clinical characteristics during rehabilitation period of youth stroke patients_West China Medical Journal

Authors：

LI Zhifeng ^1,2 , YUAN Liuqing ³ , HUA Yan ⁴ , LU Rongrong ⁴ , JIANG Congyu ¹ ,  BAI Yulong ^1,4

1. Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, P. R. China;
2. Department of Rehabilitation Medicine, Minhang Hospital, Fudan University, Shanghai 201100, P. R. China;
3. Department of Rehabilitation Medicine, Lanshaninyi City People Hospital, Linyi, Shandong 276002, P. R. China;
4. Department of Rehabilitation Medicine, North Huashan Hospital, Fudan University, Shanghai 201907, P. R. China;

Corresponding?author：

BAI Yulong, Email: dr_baiyl@fudan.edu.cn

Keywords：

Stroke; Youth; Rehabilitation period

DOI：

10.7507/1002-0179.202102014

Video：

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Objective To explore the differences of rehabilitation clinical characteristics between youth stroke patients and middle and old age stroke patients, to provide references for secondary prevention and personalized rehabilitation treatment for youth stroke.Methods From May 2016 to October 2019, stroke inpatient in the Department of Rehabilitation Medicine of Huashan Hospital of Fudan University were included. Patients were divided into youth group and middle and old age group according to their age. The clinical characteristics of the two groups during the rehabilitation period were analyzed.Results A total of 271 patients were included, including 70 in the youth group and 201 in the middle and old age group. The proportion of patients with hypertension (85.07% vs. 71.43%), diabetes (34.83% vs. 17.14%) and infection (20.90% vs. 8.57%) in the middle and old age group were higher than those in the youth group (P<0.05). The proportion of patients with hemorrhagic stroke (71.43% vs. 32.84%), history of stroke surgery (54.29% vs. 13.43%), epilepsy secondary to stroke (31.43% vs. 4.48%) and overweight/obesity (57.14% vs. 42.79%) in the youth group were higher than those in the middle and old age group (P<0.05). There was no significant difference in the proportion of gender, cognitive impairment, and thinness between the two groups (P>0.05). Among patients whose disease course was within 1 month at the time of admission, there was no significant difference in Brunnstrom stage of upper limbs-hands-lower limbs between the two groups (P>0.05). The scores of Berg Balance Scale (Z=?2.493, P=0.013) and Barthel Index (Z=?2.527, P=0.012) in the youth group were higher than those in the middle and old age group. Among patients whose disease course was between 1 month and 3 months at the time of admission, there was no significant difference in Brunnstrom stage of upper limbs-hands-lower limbs and Barthel Index between the two groups (P>0.05). The scores of Berg Balance Scale in the youth group were higher than those in the middle and old age group (Z=?2.004, P=0.045). Among patients whose disease course was more than 3 months at the time of admission, there was no significant difference in the scores of Berg Balance Scale, Barthel Index, and Brunnstrom stage of upper limbs-hands-lower limbs between the two groups (P>0.05).Conclusions For youth stroke patients, weight control is very important, and it is necessary to pay close attention to whether there are seizures. In the case of patients with stable vital signs in the early stage of the disease, more active rehabilitation treatment can be given.

Citation： LI Zhifeng, YUAN Liuqing, HUA Yan, LU Rongrong, JIANG Congyu, BAI Yulong. Clinical characteristics during rehabilitation period of youth stroke patients. West China Medical Journal, 2021, 36(5): 582-587. doi: 10.7507/1002-0179.202102014 Copy

1.	Johnston SC, Mendis S, Mathers CD. Global variation in stroke burden and mortality: estimates from monitoring, surveillance, and modelling. Lancet Neurol, 2009, 8(4): 345-354.
2.	Feigin VL. Anthology of stroke epidemiology in the 20th and 21st centuries: assessing the past, the present, and envisioning the future. Int J Stroke, 2019, 14(3): 223-237.
3.	Wang W, Jiang B, Sun H, et al. Prevalence, incidence, and mortality of stroke in China: results from a nationwide population-based survey of 480?687 adults. Circulation, 2017, 135(8): 759-771.
4.	Maaijwee NA, Rutten-Jacobs LC, Schaapsmeerders P, et al. Ischaemic stroke in young adults: risk factors and long-term consequences. Nat Rev Neurol, 2014, 10(6): 315-325.
5.	Tatlisumak T, Cucchiara B, Kuroda S, et al. Nontraumatic intracerebral haemorrhage in young adults. Nat Rev Neurol, 2018, 14(4): 237-250.
6.	Boot E, Ekker MS, Putaala J, et al. Ischaemic stroke in young adults: a global perspective. J Neurol Neurosurg Psychiatry, 2020, 91(4): 411-417.
7.	方云華, 陳善佳, 周小炫, 等. MoCA、MMSE、NCSE 等 6 個腦卒中認知康復評價工具的使用現狀調查. 中國康復, 2014, 29(1): 40-42.
8.	王賽華, 施加加, 孫瑩, 等. 簡體版改良 Barthel 指數在腦卒中恢復期中的信度與效度研究. 中國康復, 2020, 35(4): 179-182.
9.	李欣, 岳陽, 陳光榮. 腦卒中患者根據 Brunnstrom 分期采用針對性康復方案效果分析. 中國現代藥物應用, 2016(6): 1-3.
10.	甕長水, 王軍, 王剛, 等. Berg 平衡量表在腦卒中患者中的內在信度和同時效度. 中國康復醫學雜志, 2007, 22(8): 688-690, 717.
11.	von Sarnowski B, Putaala J, Grittner U, et al. Lifestyle risk factors for ischemic stroke and transient ischemic attack in young adults in the Stroke in young fabry patients study. Stroke, 2013, 44(1): 119-125.
12.	Li F, Yang L, Yang R, et al. Ischemic stroke in young adults of northern China: characteristics and risk factors for recurrence. Eur Neurol, 2017, 77(3/4): 115-122.
13.	Bhaskaran K, Dos-Santos-Silva I, Leon DA, et al. Association of BMI with overall and cause-specific mortality: a population-based cohort study of 3·6 million adults in the UK. Lancet Diabetes Endocrinol, 2018, 6(12): 944-953.
14.	Mitchell AB, Cole JW, McArdle PF, et al. Obesity increases risk of ischemic stroke in young adults. Stroke, 2015, 46(6): 1690-1692.
15.	Park D, Lee JH, Han S. Underweight: another risk factor for cardiovascular disease?: a cross-sectional 2013 Behavioral Risk Factor Surveillance System (BRFSS) study of 491, 773 individuals in the USA. Medicine (Baltimore), 2017, 96(48): e8769.
16.	Duarte AA, Mohsin S, Golubnitschaja O. Diabetes care in figures: current pitfalls and future scenario. EPMA J, 2018, 9(2): 125-131.
17.	Silverman IE, Restrepo L, Mathews GC. Poststroke seizures. Arch Neurol, 2002, 59(2): 195-201.
18.	Zou S, Wu X, Zhu B, et al. The pooled incidence of post-stroke seizure in 102?008 patients. Top Stroke Rehabil, 2015, 22(6): 460-467.
19.	Wang JZ, Vyas MV, Saposnik G, et al. Incidence and management of seizures after ischemic stroke: systematic review and meta-analysis. Neurology, 2017, 89(12): 1220-1228.
20.	Zhang C, Wang X, Wang Y, et al. Risk factors for post-stroke seizures: a systematic review and meta-analysis. Epilepsy Res, 2014, 108(10): 1806-1816.
21.	Burneo JG, Fang J, Saposnik G, et al. Impact of seizures on morbidity and mortality after stroke: a Canadian multi-centre cohort study. Eur J Neurol, 2010, 17(1): 52-58.
22.	Huang CW, Saposnik G, Fang J, et al. Influence of seizures on stroke outcomes: a large multicenter study. Neurology, 2014, 82(9): 768-776.
23.	Yeh SJ, Huang KY, Wang TG, et al. Dysphagia screening decreases pneumonia in acute stroke patients admitted to the stroke intensive care unit. J Neurol Sci, 2011, 306(1/2): 38-41.
24.	Boehme AK, Kumar AD, Dorsey AM, et al. Infections present on admission compared with hospital-acquired infections in acute ischemic stroke patients. J Stroke Cerebrovasc Dis, 2013, 22(8): e582-e589.
25.	Shah SV, Corado C, Bergman D, et al. Impact of poststroke medical complications on 30-day readmission rate. J Stroke Cerebrovasc Dis, 2015, 24(9): 1969-1977.

1. Johnston SC, Mendis S, Mathers CD. Global variation in stroke burden and mortality: estimates from monitoring, surveillance, and modelling. Lancet Neurol, 2009, 8(4): 345-354.
2. Feigin VL. Anthology of stroke epidemiology in the 20th and 21st centuries: assessing the past, the present, and envisioning the future. Int J Stroke, 2019, 14(3): 223-237.
3. Wang W, Jiang B, Sun H, et al. Prevalence, incidence, and mortality of stroke in China: results from a nationwide population-based survey of 480?687 adults. Circulation, 2017, 135(8): 759-771.
4. Maaijwee NA, Rutten-Jacobs LC, Schaapsmeerders P, et al. Ischaemic stroke in young adults: risk factors and long-term consequences. Nat Rev Neurol, 2014, 10(6): 315-325.
5. Tatlisumak T, Cucchiara B, Kuroda S, et al. Nontraumatic intracerebral haemorrhage in young adults. Nat Rev Neurol, 2018, 14(4): 237-250.
6. Boot E, Ekker MS, Putaala J, et al. Ischaemic stroke in young adults: a global perspective. J Neurol Neurosurg Psychiatry, 2020, 91(4): 411-417.
7. 方云華, 陳善佳, 周小炫, 等. MoCA、MMSE、NCSE 等 6 個腦卒中認知康復評價工具的使用現狀調查. 中國康復, 2014, 29(1): 40-42.
8. 王賽華, 施加加, 孫瑩, 等. 簡體版改良 Barthel 指數在腦卒中恢復期中的信度與效度研究. 中國康復, 2020, 35(4): 179-182.
9. 李欣, 岳陽, 陳光榮. 腦卒中患者根據 Brunnstrom 分期采用針對性康復方案效果分析. 中國現代藥物應用, 2016(6): 1-3.
10. 甕長水, 王軍, 王剛, 等. Berg 平衡量表在腦卒中患者中的內在信度和同時效度. 中國康復醫學雜志, 2007, 22(8): 688-690, 717.
11. von Sarnowski B, Putaala J, Grittner U, et al. Lifestyle risk factors for ischemic stroke and transient ischemic attack in young adults in the Stroke in young fabry patients study. Stroke, 2013, 44(1): 119-125.
12. Li F, Yang L, Yang R, et al. Ischemic stroke in young adults of northern China: characteristics and risk factors for recurrence. Eur Neurol, 2017, 77(3/4): 115-122.
13. Bhaskaran K, Dos-Santos-Silva I, Leon DA, et al. Association of BMI with overall and cause-specific mortality: a population-based cohort study of 3·6 million adults in the UK. Lancet Diabetes Endocrinol, 2018, 6(12): 944-953.
14. Mitchell AB, Cole JW, McArdle PF, et al. Obesity increases risk of ischemic stroke in young adults. Stroke, 2015, 46(6): 1690-1692.
15. Park D, Lee JH, Han S. Underweight: another risk factor for cardiovascular disease?: a cross-sectional 2013 Behavioral Risk Factor Surveillance System (BRFSS) study of 491, 773 individuals in the USA. Medicine (Baltimore), 2017, 96(48): e8769.
16. Duarte AA, Mohsin S, Golubnitschaja O. Diabetes care in figures: current pitfalls and future scenario. EPMA J, 2018, 9(2): 125-131.
17. Silverman IE, Restrepo L, Mathews GC. Poststroke seizures. Arch Neurol, 2002, 59(2): 195-201.
18. Zou S, Wu X, Zhu B, et al. The pooled incidence of post-stroke seizure in 102?008 patients. Top Stroke Rehabil, 2015, 22(6): 460-467.
19. Wang JZ, Vyas MV, Saposnik G, et al. Incidence and management of seizures after ischemic stroke: systematic review and meta-analysis. Neurology, 2017, 89(12): 1220-1228.
20. Zhang C, Wang X, Wang Y, et al. Risk factors for post-stroke seizures: a systematic review and meta-analysis. Epilepsy Res, 2014, 108(10): 1806-1816.
21. Burneo JG, Fang J, Saposnik G, et al. Impact of seizures on morbidity and mortality after stroke: a Canadian multi-centre cohort study. Eur J Neurol, 2010, 17(1): 52-58.
22. Huang CW, Saposnik G, Fang J, et al. Influence of seizures on stroke outcomes: a large multicenter study. Neurology, 2014, 82(9): 768-776.
23. Yeh SJ, Huang KY, Wang TG, et al. Dysphagia screening decreases pneumonia in acute stroke patients admitted to the stroke intensive care unit. J Neurol Sci, 2011, 306(1/2): 38-41.
24. Boehme AK, Kumar AD, Dorsey AM, et al. Infections present on admission compared with hospital-acquired infections in acute ischemic stroke patients. J Stroke Cerebrovasc Dis, 2013, 22(8): e582-e589.
25. Shah SV, Corado C, Bergman D, et al. Impact of poststroke medical complications on 30-day readmission rate. J Stroke Cerebrovasc Dis, 2015, 24(9): 1969-1977.

West China Medical Journal

Clinical characteristics during rehabilitation period of youth stroke patients

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