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对急性中风患者的中风病房护理:一项观察性随访研究
Livia Candelise1, Monica Gattinoni, Anna Bersano
1Dipartimento di Scienze Neurologiche, Ospedale Maggiore Policlinico IRCCS, Università degli Studi di Milano, Milan, Italy. livia.candelise@unimi.it
Lancet (London, England)
|January 30, 2007
概括
脑卒中单位的护理显著降低了急性脑卒中患者的死亡率和残疾. 建议在48小时内提前进入专门的中风病房,以获得更好的患者结果.
科学领域:
- 神经学 神经学
- 公共卫生 公共卫生
- 医疗保健管理的管理
背景情况:
- 对中风有有效的急性治疗方法,但支持中风病房护理的证据有限.
- 许多中风患者在急性阶段需要住院治疗.
- 这项研究解决了对中风病房护理与传统病房护理的好处的证据需求.
研究的目的:
- 评估中风病房护理对患者结局的影响,与传统病房护理相比.
- 为了确定是否专门的中风单位提高了急性中风患者的生存率和功能状态.
- 为推中风病房入院治疗急性中风管理提供证据.
主要方法:
- 一项观察后续研究,涉及11572名急性中风患者.
- 患者在症状出现后48小时内被接收到中风病房 (4,936) 或常规病房 (6,636).
- 结果 (死亡率或残疾) 在2年后使用修改后的兰金度量表进行评估,并根据患者和医院级因素调整了分析.
主要成果:
- 在2年随访后,中风病房护理与死亡或残疾的可能性显著降低有关 (OR 0.81,95% CI 0.72-0.91;p=0.0001).
- 这种益处在各种年龄组和临床特征中观察到,不包括无意识的患者.
- 在中风单位内,没有特定的组织或流程元素与改善的结果有独特的联系.
结论:
- 建议所有急性中风患者在中风发作后48小时内进入中风病房.
- 专门设有专门的床位和工作人员的专业中风病房似乎可以改善患者的治疗结果.
- 这些发现支持将中风病房护理纳入急性中风管理的标准实践.
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