ObjectiveTo categorize and describe stroke-patients based on factors related to patient reported outcomes. MethodsA questionnaire survey was conducted among stroke-patients in nine hospitals and communities in Shanxi Province. The general information questionnaire and stroke-patient reported outcome manual (Stroke-PROM) were completed. Latent profile analysis was used to analyze the scores of Stroke-PROM, and the explicit variables of the model were the final scores of each dimension. ANOVA and correlation analysis were used to measure the correlation between the factors and subtypes. ResultsFour unique stroke-patient profiles emerged, including a low physiological and low social group (9%), a high physiological and middle social group (40%), a middle physiological and middle social group (26%), and a middle physiological and high social group (25%). There were significant differences in scores of four areas among patients with different subtypes (P<0.05). Moreover, there was a correlation between age, payment, exercise and subtypes (P<0.05). ConclusionThere are obvious grouping characteristics for stroke patients. It is necessary to focus on stroke patients who are advanced in age, have a self-funded status and lack exercise, and provide targeted nursing measures to improve their quality of life.
ObjectiveThe re-hospitalization and death events of patients heart failure caused by coronary heart disease are characterized by non-independence, heterogeneity, and censored data. A joint frailty model is established to jointly model the events, explore the risk factors affecting the prognosis of patients, and reduce the re-hospitalization rate and mortality of patients. MethodsThe sample includes 4 682 patients with heart failure caused by coronary heart disease in two tertiary hospitals from January 2014 and June 2019. The electronic medical record information of patients during hospitalization and their follow-up information were collected. The Cox model, conditional frailty model and joint frailty model were used to analyze patient re-hospitalization and death. ResultsThe joint frailty model identifies patients with a higher risk of both relapse and death (θ=0.209, P<0.001). Risk factors for re-hospitalization were advanced age, Grade 3 hypertension, mental work, no medical insurance, high cystatin C, and low ejection fraction, plus, within certain limits, low free thyroxine-3 and thyroxine-4. Antiplatelet drugs and statins significantly reduced the risk of re-hospitalization. Risk factors for death were advanced age, New York Heart Association classification Ⅲ to Ⅳ, no medical insurance, mental work, high cystatin C level, high troponin-I level, low free thyroxine-3, and low ejection fraction. Percutaneous coronary intervention, and taking antiplatelet drugs and statins significantly reduced the risk of death. ConclusionThe joint frailty model can simultaneously model recurring and terminal events, and accurately predict them. Our results suggest that thyroid hormone levels and cystatin C levels of patients should be considered more carefully. People with mental jobs should change bad working habits to reduce adverse outcomes.