| Background:Stroke has become a serious threat to human health. It is one of important diseases with high incidence, high mortality, high disablerate and high recurrence rate. Prognostic factors of stroke have become the focus of attention to the clinical and health system. Today, we focus to the applicability of Traditional Chinese Medicine(TCM) to stroke registration system, through long-term follow-up to explore the relationship between the prognosis and syndromes of TCM.Objective:To analyze the factors, which may influence the prognosis of the stroke patients, especially for the initial syndromes of TCM, and provide evidences to improve the prognosis and the life-time of stroke patients.Methods:By means of the stroke registration system of Guangdong Provincial Hospital of TCM, the cases were interviewed continuously from Oct 1, 2005 to Sep 30, 2006. The follow-ups were implemented at the end of the first month, the third month, the sixth month and the first year after stroke. Survival situation and BI scores of patients were assessed at the four time points. The general situation and distribution of the syndromes of TCM were analyed descriptively. Then the prognsis analysis was performed on the basis of application of the univariate analysis for each follow-up time point for the prognostic factors, multi-variate logistic regressions were applied to analysis BI and survival status related to the prognostic factors. Finally, the Cox-model was used to analyed and established the survival model for syndromes of TCM.Results: Totally 367 cases of stroke met the diagnostic and inclusion criteria. For the syndromes of TCM: Among six single TCM syndromes, the Feng Syndrome and the Sputum Syndrome were highest frequent. Double-combined Syndromes and Triple-combined Syndrome of TCM were also frequent in the patients. For prognostic factors analysis: the result of univariate analysis indicated that the poor prognosis included NIHSS score, the number of days of hospitalization. The prognostic factors at three time points were age, radiological nature, the type of TCM of stroke, fasting plasma glucose, the number of Syndrome. The Sputum Syndrome has a relationship at two follow-up points. The prognosis factor at a single point were the admission-prolong time and sex.Logistic regression analysis showed that the significant factors included age, radiological nature, NIHSS score for the poor prognosis (BI＜60). The prognostic factor at two time points were the Fire-heat Syndrome of TCM, days of hospitalization. The prognostic factor at one time point were the fasting plasma glucose, gender, the delay time of admission. The independent prognostic factors for death status were age, diastolic blood pressure, the Qi-deficiency Syndrome of TCM.The prognostic factors for death at three time points were the NIHSS score, radiological nature, number of days hospitalized, the type of TCM of stroke. The history of hypertension was a prognostic factors for death at two points of interview. The prognostic factors death at one point of intervew were fasting blood glucose, the Fire-heat Syndrome of TCM.The results of survival analysis showed that the factors related to survival time included age, fasting plasma glucose, radiological nature, the type of TCM of stroke, the Qi-deficiency Syndrome. Additionly we establish a survival model which displayed a good predictability.Conclusion:The prognosis of stroke relate to a variety of factors, espically to age, NIHSS score, days of hospitalization. The initial syndromes such as Fire-heat Syndrome of TCM and Sputum Syndrome, the type of TCM of stroke were significant prognosis factors for acute stroke. The Qi-deficiency Syndrome was prognostic factor for death and survival time. |
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