Background: functional status at the onset of stroke is an important component that determines treatment and rehabilitation tactics.
Aims: to study the relationship between gender and age characteristics, stroke type, comorbid status, travel time to the hospital and the severity of the functional state at the hospitalization time in patients with stroke living in the Arkhangelsk region.
Materials and methods: in a retrospective longitudinal study, factors influencing the patient’s functional status at the time of hospitalization were studied: gender, age, stroke type, concomitant diseases, travel time to the hospital. Multivariate analyzes were performed on models assessing outcome by mean National Institutes of Health Stroke Scale (NIHSS) score as relative risk (RR) using Poisson regression; using median regression (MR) for NIHSS; MR for the modified Rankin scale (mRs).
Results: The study included 5221 people in the acute period of stroke. With increasing age, the number of NIHSS scores increased, significantly in patients over 70. In women, the average NIHSS score was 1.11 times higher relative to men (95% CI: 1.08; 1.13), the median mRs score was 0.2 lower (95% CI: 0.08; 0.33). The mean NIHSS value in patients with hemorrhagic stroke (HS) was 1.3 times (95% CI: 1.24;1.34) higher than in patients with cardioembolic stroke (CES), the median mRs score in patients with HS was 0 .7 higher (95% CI: 0.46: 1.04). As travel time increased, the mean NIHSS and median mRs scores decreased. Arterial hypertension (AH) increased the average NIHSS by 1.16 times (95% CI: 1.09;1.23), obesity by 1.16 (95% CI: 1.10;1.21), CHF by 1.13 (95% CI: 1.10;1.16), CKD by 1.12 (95% CI: 1.09;1.16), cancer by 6% (95% CI: 1.01 ;1.10) and coronary heart disease by 3% (95% CI: 1.00;1.05). When assessed by mRS, only the presence of CHF increased the median score by 0.2 (95% CI: 0.05, 0.35).
Conclusions: The main predictors of the severity of the functional status at the time of hospitalization, which appeared in all models, were female gender, elderly and senile age, HS and CHF. The studied predictors are not the same in significance and degree of influence when assessing the outcome on different scales.