Background In-hospital medical complications are associated with poorer clinical outcomes for stroke patients after disease onset. However, few studies from China have reported the effect of these complications on the...Background In-hospital medical complications are associated with poorer clinical outcomes for stroke patients after disease onset. However, few studies from China have reported the effect of these complications on the mortality of patients with acute ischemic stroke. In this prospective work, the China National Stroke Registry Study, we investigated the effect of medical complications on the case fatality of patients with acute ischemic stroke. Methods From September 2007 to August 2008, we prospectively obtained the data of patients with acute stroke from 132 clinical centers in China. Medical complications, case fatality and other information recorded at baseline, during hospitalisation, and at 3, 6, and 12 months after stroke onset. Multivariable Logistic regression was performed to analyze the effect of medical complications on the case fatality of patients with acute ischemic stroke. Results There were 39741 patients screened, 14526 patients with acute ischemic stroke recruited, and 11 560 ischemic stroke patients without missing data identified during the 12-month follow-up. Of the 11 560 ischemic patients, 15.8% （1826） had in-hospital medical complications. The most common complication was pneumonia （1373; 11.9% of patients）, followed by urinary tract infection and gastrointestinal bleeding. In comparison with patients without complications, stroke patients with complications had a significantly higher risk of death during their hospitalization, and at 3, 6 and 12 months post-stroke. Having any one in-hospital medical complication was an independent risk factor for death in patients with acute ischemic stroke during hospital period （adjusted OR=6.946; 95% CI 5.181 to 9.314）, at 3 months （adjusted OR=3.843; 95% C/3.221 to 4.584）, 6 months （adjusted OR=3.492; 95% CI 2.970 to 4.106）, and 12 months （adjusted OR= 3.511; 95% CI 3.021 to 4.080）. Having multiple complications strongly increased the death risk of patients. Conclusion Short-term and long-term outcomes of acute stroke patients展开更多
Background:The 2019 novel coronavirus has caused the outbreak of the acute respiratory disease in Wuhan,Hubei Province of China since December 2019.This study was performed to analyze the clinical characteristics of p...Background:The 2019 novel coronavirus has caused the outbreak of the acute respiratory disease in Wuhan,Hubei Province of China since December 2019.This study was performed to analyze the clinical characteristics of patients who succumbed to and who recovered from 2019 novel coronavirus disease(COVID-19).Methods:Clinical data were collected from two tertiary hospitals in Wuhan.A retrospective investigation was conducted to analyze the clinical characteristics of fatal cases of COVID-19(death group)and we compare them with recovered patients(recovered group).Continuous variables were analyzed using the Mann-WhitneyU test.Categorical variables were analyzed byχ2 test or Fisher exact test as appropriate.Results:Our study enrolled 109 COVID-19 patients who died during hospitalization and 116 recovered patients.The median age of the death group was older than the recovered group(69[62,74]vs.40[33,57]years,Z=9.738,P<0.001).More patients in the death group had underlying diseases(72.5%vs.41.4%,χ2=22.105,P<0.001).Patients in the death group had a significantly longer time of illness onset to hospitalization(10.0[6.5,12.0]vs.7.0[5.0,10.0]days,Z=3.216,P=0.001).On admission,the proportions of patients with symptoms of dyspnea(70.6%vs.19.0%,χ2=60.905,P<0.001)and expectoration(32.1%vs.12.1%,χ2=13.250,P<0.001)were significantly higher in the death group.The blood oxygen saturation was significantly lower in the death group(85[77,91]%vs.97[95,98]%,Z=10.625,P<0.001).The white blood cell(WBC)in death group was significantly higher on admission(7.23[4.87,11.17]vs.4.52[3.62,5.88]×109/L,Z=7.618,P<0.001).Patients in the death group exhibited significantly lower lymphocyte count(0.63[0.40,0.79]vs.1.00[0.72,1.27]×109/L,Z=8.037,P<0.001)and lymphocyte percentage(7.10[4.45,12.73]%vs.23.50[15.27,31.25]%,Z=10.315,P<0.001)on admission,and the lymphocyte percentage continued to decrease during hospitalization(7.10[4.45,12.73]%vs.2.91[1.79,6.13]%,Z=5.242,P<0.001).Alanine transaminase(22.00[15.00,34.00]vs.18.70[13.00,30.38]U/L,Z=2.592,P=0展开更多
目的探讨急性缺血性脑卒中患者体质量指数(body mass index,BMI)与临床预后及病死率的关系。方法回顾性收集2017年8月至2018年12月于武汉大学人民医院神经内科住院的568例急性缺血性脑卒中患者,收集其临床资料,记录其年龄、性别、BMI、...目的探讨急性缺血性脑卒中患者体质量指数(body mass index,BMI)与临床预后及病死率的关系。方法回顾性收集2017年8月至2018年12月于武汉大学人民医院神经内科住院的568例急性缺血性脑卒中患者,收集其临床资料,记录其年龄、性别、BMI、血管危险因素、美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分、基线血压、空腹血糖等基线资料。根据患者BMI将患者分为4个体质量亚组:体质量过轻组(BMI<18.5 kg/m^2)、正常体质量组(18.5≤BMI<24 kg/m^2),超重组(24≤BMI<28 kg/m^2)以及肥胖组(BMI≥28 kg/m^2)。采用改良Rankin量表(mRS)评分对患者发病后90 d临床预后进行评价(mRS评分>2为预后不良,mRS评分≤2分为预后良好)。用逻辑回归分析BMI与临床预后及病死率的相关性。结果在调整年龄、性别、血管危险因素、NIHSS评分以及脑梗死病因分型等因素影响后,体质量过轻组与正常体质量组相比,90 d预后不良风险显著增加(OR=2.385,95%CI:1.042~5.454;P=0.039);肥胖组90 d预后不良风险差异无统计学意义(OR=0.570,95%CI:0.261~1.248,P=0.160)。体质量过轻组与正常体质量组相比,90 d死亡风险显著增加(OR=2.760,95%CI:1.073~7.098;P=0.035);肥胖组与正常体质量组相比,90 d死亡风险差异无统计学意义(OR=0.349,95%CI:0.099~1.229,P=0.101)。结论体质量过轻的急性缺血性脑卒中患者临床预后不良,有着更高的病死率和致残风险。展开更多
目的了解2015—2017年湖州市脑卒中流行状况,为其防治工作提供数据支持。方法计算不同亚型(出血性和缺血性)脑卒中发病率、死亡率、病死率、潜在减寿年等,采用趋势检验、χ2检验进行统计分析。结果2015—2017年湖州市缺血性脑卒中年均...目的了解2015—2017年湖州市脑卒中流行状况,为其防治工作提供数据支持。方法计算不同亚型(出血性和缺血性)脑卒中发病率、死亡率、病死率、潜在减寿年等,采用趋势检验、χ2检验进行统计分析。结果2015—2017年湖州市缺血性脑卒中年均发病率316.66/10万(中标率239.67/10万),死亡率29.43/10万(中标率20.39/10万);出血性脑卒中年均发病率73.53/10万(中标率57.10/10万),死亡率31.18/10万(中标率22.34/10万);年均病死率为15.53%,其中男性为15.44%,女性为15.64%。出血性脑卒中病死率高于缺血性脑卒中,两类脑卒中发病率及死亡率均随着年龄增长而呈上升趋势(缺血性:Z=251.918、Z=100.977,P<0.01;出血性:Z=104.022、Z=93.312,P<0.01)。脑卒中病死率无明显变化趋势(Z=-0.857,P=0.3914)。在季节分布上,缺血性脑卒中发病数夏季最高;出血性脑卒中发病数为春季最高,其次冬季。缺血性脑卒中平均减寿年数(average years of life lost,AYLL)为6.71年,潜在减寿率(potential years of life lost rate,PYLLR)为0.22‰;出血性脑卒中AYLL为10.28年,PYLLR为0.77‰,男性减寿程度高于女性。结论湖州市缺血性脑卒中发病率和死亡率总体呈上升趋势,出血性脑卒中发病率和死亡率总体无明显变化;两类脑卒中发病率和死亡率均随着年龄增长而上升、男性高于女性,脑卒中发病季节集中在春夏冬三季。展开更多
This article compares the size of selected subsets using nonparametric subset selection rules with two different scoring rules for the observations. The scoring rules are based on the expected values of order statisti...This article compares the size of selected subsets using nonparametric subset selection rules with two different scoring rules for the observations. The scoring rules are based on the expected values of order statistics of the uniform distribution (yielding rank values) and of the normal distribution (yielding normal score values). The comparison is made using state motor vehicle traffic fatality rates, published in a 2016 article, with fifty-one states (including DC as a state) and over a nineteen-year period (1994 through 2012). The earlier study considered four block design selection rules—two for choosing a subset to contain the “best” population (i.e., state with lowest mean fatality rate) and two for the “worst” population (i.e., highest mean rate) with a probability of correct selection chosen to be 0.90. Two selection rules based on normal scores resulted in selected subset sizes substantially smaller than corresponding rules based on ranks (7 vs. 16 and 3 vs. 12). For two other selection rules, the subsets chosen were very close in size (within one). A comparison is also made using state homicide rates, published in a 2022 article, with fifty states and covering eight years. The results are qualitatively the same as those obtained with the motor vehicle traffic fatality rates.展开更多
文摘Background In-hospital medical complications are associated with poorer clinical outcomes for stroke patients after disease onset. However, few studies from China have reported the effect of these complications on the mortality of patients with acute ischemic stroke. In this prospective work, the China National Stroke Registry Study, we investigated the effect of medical complications on the case fatality of patients with acute ischemic stroke. Methods From September 2007 to August 2008, we prospectively obtained the data of patients with acute stroke from 132 clinical centers in China. Medical complications, case fatality and other information recorded at baseline, during hospitalisation, and at 3, 6, and 12 months after stroke onset. Multivariable Logistic regression was performed to analyze the effect of medical complications on the case fatality of patients with acute ischemic stroke. Results There were 39741 patients screened, 14526 patients with acute ischemic stroke recruited, and 11 560 ischemic stroke patients without missing data identified during the 12-month follow-up. Of the 11 560 ischemic patients, 15.8% （1826） had in-hospital medical complications. The most common complication was pneumonia （1373; 11.9% of patients）, followed by urinary tract infection and gastrointestinal bleeding. In comparison with patients without complications, stroke patients with complications had a significantly higher risk of death during their hospitalization, and at 3, 6 and 12 months post-stroke. Having any one in-hospital medical complication was an independent risk factor for death in patients with acute ischemic stroke during hospital period （adjusted OR=6.946; 95% CI 5.181 to 9.314）, at 3 months （adjusted OR=3.843; 95% C/3.221 to 4.584）, 6 months （adjusted OR=3.492; 95% CI 2.970 to 4.106）, and 12 months （adjusted OR= 3.511; 95% CI 3.021 to 4.080）. Having multiple complications strongly increased the death risk of patients. Conclusion Short-term and long-term outcomes of acute stroke patients
文摘Background:The 2019 novel coronavirus has caused the outbreak of the acute respiratory disease in Wuhan,Hubei Province of China since December 2019.This study was performed to analyze the clinical characteristics of patients who succumbed to and who recovered from 2019 novel coronavirus disease(COVID-19).Methods:Clinical data were collected from two tertiary hospitals in Wuhan.A retrospective investigation was conducted to analyze the clinical characteristics of fatal cases of COVID-19(death group)and we compare them with recovered patients(recovered group).Continuous variables were analyzed using the Mann-WhitneyU test.Categorical variables were analyzed byχ2 test or Fisher exact test as appropriate.Results:Our study enrolled 109 COVID-19 patients who died during hospitalization and 116 recovered patients.The median age of the death group was older than the recovered group(69[62,74]vs.40[33,57]years,Z=9.738,P<0.001).More patients in the death group had underlying diseases(72.5%vs.41.4%,χ2=22.105,P<0.001).Patients in the death group had a significantly longer time of illness onset to hospitalization(10.0[6.5,12.0]vs.7.0[5.0,10.0]days,Z=3.216,P=0.001).On admission,the proportions of patients with symptoms of dyspnea(70.6%vs.19.0%,χ2=60.905,P<0.001)and expectoration(32.1%vs.12.1%,χ2=13.250,P<0.001)were significantly higher in the death group.The blood oxygen saturation was significantly lower in the death group(85[77,91]%vs.97[95,98]%,Z=10.625,P<0.001).The white blood cell(WBC)in death group was significantly higher on admission(7.23[4.87,11.17]vs.4.52[3.62,5.88]×109/L,Z=7.618,P<0.001).Patients in the death group exhibited significantly lower lymphocyte count(0.63[0.40,0.79]vs.1.00[0.72,1.27]×109/L,Z=8.037,P<0.001)and lymphocyte percentage(7.10[4.45,12.73]%vs.23.50[15.27,31.25]%,Z=10.315,P<0.001)on admission,and the lymphocyte percentage continued to decrease during hospitalization(7.10[4.45,12.73]%vs.2.91[1.79,6.13]%,Z=5.242,P<0.001).Alanine transaminase(22.00[15.00,34.00]vs.18.70[13.00,30.38]U/L,Z=2.592,P=0
文摘目的了解2015—2017年湖州市脑卒中流行状况,为其防治工作提供数据支持。方法计算不同亚型(出血性和缺血性)脑卒中发病率、死亡率、病死率、潜在减寿年等,采用趋势检验、χ2检验进行统计分析。结果2015—2017年湖州市缺血性脑卒中年均发病率316.66/10万(中标率239.67/10万),死亡率29.43/10万(中标率20.39/10万);出血性脑卒中年均发病率73.53/10万(中标率57.10/10万),死亡率31.18/10万(中标率22.34/10万);年均病死率为15.53%,其中男性为15.44%,女性为15.64%。出血性脑卒中病死率高于缺血性脑卒中,两类脑卒中发病率及死亡率均随着年龄增长而呈上升趋势(缺血性:Z=251.918、Z=100.977,P<0.01;出血性:Z=104.022、Z=93.312,P<0.01)。脑卒中病死率无明显变化趋势(Z=-0.857,P=0.3914)。在季节分布上,缺血性脑卒中发病数夏季最高;出血性脑卒中发病数为春季最高,其次冬季。缺血性脑卒中平均减寿年数(average years of life lost,AYLL)为6.71年,潜在减寿率(potential years of life lost rate,PYLLR)为0.22‰;出血性脑卒中AYLL为10.28年,PYLLR为0.77‰,男性减寿程度高于女性。结论湖州市缺血性脑卒中发病率和死亡率总体呈上升趋势,出血性脑卒中发病率和死亡率总体无明显变化;两类脑卒中发病率和死亡率均随着年龄增长而上升、男性高于女性,脑卒中发病季节集中在春夏冬三季。
文摘This article compares the size of selected subsets using nonparametric subset selection rules with two different scoring rules for the observations. The scoring rules are based on the expected values of order statistics of the uniform distribution (yielding rank values) and of the normal distribution (yielding normal score values). The comparison is made using state motor vehicle traffic fatality rates, published in a 2016 article, with fifty-one states (including DC as a state) and over a nineteen-year period (1994 through 2012). The earlier study considered four block design selection rules—two for choosing a subset to contain the “best” population (i.e., state with lowest mean fatality rate) and two for the “worst” population (i.e., highest mean rate) with a probability of correct selection chosen to be 0.90. Two selection rules based on normal scores resulted in selected subset sizes substantially smaller than corresponding rules based on ranks (7 vs. 16 and 3 vs. 12). For two other selection rules, the subsets chosen were very close in size (within one). A comparison is also made using state homicide rates, published in a 2022 article, with fifty states and covering eight years. The results are qualitatively the same as those obtained with the motor vehicle traffic fatality rates.
