| 제목 |
Multi-facet Functional Changes to 4 Year after the First-ever Strokes in Korea: The KOSCO Study |
| 소속 |
Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Physical and Rehabilitation Medicine1, Chungnam National University, Department of Rehabilitation Medicine, School of Medicine2, Konkuk University School of Medicine, Department of Rehabilitation Medicine3, Yonsei University College of Medicine, Department and Research Institute of Rehabilitation Medicine4, Chonnam National University Medical School, Department of Physical and Rehabilitation Medicine5, Pusan National University School of Medicine, Pusan National University Yangsan Hospital , Department of Rehabilitation Medicine6, Wonkwang University, School of Medicine, Department of Preventive Medicine7, Kyungpook National University School of Medicine, Kyungpook National University Hospital, Department of Rehabilitation Medicine8, Wonkwang University School of Medicine, Department of Rehabilitation Medicine9, Jeju National University Hospital, Jeju National University School of Medicine, Department of Rehabilitation Medicine10, Hallym University, Department of Statistics11, Ewha Womans University, Department of Health Convergence12, Korea Centers for Disease Control and Prevention, Division of Chronic Disease Prevention, Center for Disease13, SAIHST, Sungkyunkwan University, Department of Health Science and Technology, Department of Medical Device Management and Research14 |
| 저자 |
Sang Moon Yun1*, Min Kyun Sohn2, Jongmin Lee3, Deog Young Kim4, Sam-Gyu Lee5, Yong-Il Shin6, Gyung-Jae Oh7, Yang-Soo Lee8, Min Cheol Joo9, So Young Lee10, Junhee Han11, Jeonghoon Ahn12, Young-Hoon Lee7, Min-Keun Song5, Won Hyuk Chang1, Soo Mi Choi13, Jin Ha13, Yun-Hee Kim1,14† |
Objective: There is no definite consensus on the courses of long-term multi-facet functional level in stroke patients after 6 months, although these are very important for a rehabilitation plan and national policies for disables. The purpose of this study was to analyze the functional recovery patterns from 7 days to 4 years after stroke onset and the time point to reach the plateau and decline of each function for the total, ischemic and hemorrhagic stroke.
Materials and Methods: This study was an interim analysis of the Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO) designed as 10 years long-term follow-up study of stroke patients. All patients who admitted to the representative hospitals in 9 distinct areas of Korea with their acute first-ever stroke (from August 2012 to May 2015) were recruited. Both ischemic and hemorrhagic strokes were included, but transient ischemic attacks were excluded. Out of 8,010 patients who agreed with participation, 4,564 patients completed face-to-face assessments at 4 years after stroke onset. Functional assessments included Korean modified Barthel Index (K-MBI), Korean Mini-Mental State Examination (K-MMSE), Fugl-Meyer Assessment (FMA), Functional Ambulatory Category (FAC), the American Speech-Language-Hearing Association National Outcome Measurement System Swallowing Scale (ASHA-NOMS), and Short Korean Version of Frenchay Aphasia Screening Test (Short K-FAST). We demonstrated each functional recovery pattern for total, ischemic, and hemorrhagic stroke data separately, and also for subsets grouped by their baseline stroke severities and age.
Results: Among 4,564 patients, 79.3% of patients suffered from ischemic and 20.7% hemorrhagic stroke, respectively. Their mean age was 63.1 years, and the ratio of male to female was 1.48. K-MBI reached the plateau at 12 months after stroke onset and showed no decline up to 4 years after stroke onset. However, in the patients with more than 65 years old, K-MBI showed a significant decline from 2 years to 4 years(p<0.05).
Conclusion: The results of this study demonstrated that functional decline would be expected after the 24 months in the first-ever stroke patients with more than 65 years old. Therefore the proper rehabilitation strategies should be considered in older chronic stroke patients to maintain their functional level. |
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