METHODS: We retrospectively screened records from patients with stroke admitted to our hospital from January 2015 to June 2021. Eligible patients with severe DoC were classified into two groups: patients who received standard rehabilitation (control group) and patients who received PROr (PROr group). We studied longitudinal change in the level of consciousness using the Japan Coma Scale (JCS) during hospital stay and compared in-hospital mortality, the incidence of respiratory complication, and modified Rankin Scale of discharge between the two groups.
RESULTS: Among the 2191 patients screened for inclusion, 16 patients were included in the PROr group, and 12 patients were included in the control group. Early mobilization was more promoted in the PROr group compared to the control group, but there were no significant differences in in-hospital mortality, the incidence of respiratory complication, or modified Rankin Scale at discharge between the two groups. In patients who survived during their hospital stay, JCS scores 2 weeks after the onset of stroke and JCS scores at discharge significantly improved from the start of rehabilitation in the PROr group, but not in the control group.
CONCLUSIONS: Early mobilization provided with the PROr program appears to be a safe treatment and may contribute to the improvement of consciousness level for patients with acute stroke and severe DoC.
方法:我们回顾性筛选了2015年1月至2021年6月我院收治的卒中患者的记录。符合条件的重度DoC患者分为两组:接受标准康复治疗的患者(对照组)和接受PROr治疗的患者(PROr组)。我们使用日本昏迷量表(JCS)研究了住院期间意识水平的纵向变化,并比较了住院死亡率,呼吸系统并发症的发生率,并对两组患者行改良Rankin出院评分。
结果:在筛选纳入的2191名患者中,PROr组包括16例患者,12例患者纳入对照组。与对照组相比,PROr组更有利于早期动员,但是住院死亡率没有显着差异,呼吸系统并发症的发生率,两组出院时或改良Rankin量表。在住院期间幸存的患者中,PROr组患者卒中发病后2周的JCS评分和出院时的JCS评分从康复开始显著改善,但不在对照组。
结论:PROr计划提供的早期动员似乎是一种安全的治疗方法,可能有助于改善急性卒中和严重DoC患者的意识水平。