在中风中心住院治疗急性缺血性中风和死亡率之间存在关联
Ying Xian1, Robert G Holloway, Paul S Chan
1Duke Clinical Research Institute, 2400 Pratt St, Durham, NC 27705, USA. ying.xian@duke.edu
JAMA
|January 27, 2011
概括
进入针对急性缺血性中风的指定中风中心与降低死亡率和增加使用血栓缓解疗法有关,改善了患者的治疗结果.
科学领域:
- 神经学 神经学
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 脑卒中中心得到广泛认可,但它们对患者结果的影响仍未得到充分研究.
- 了解专门的中风护理的有效性对于优化治疗策略至关重要.
研究的目的:
- 调查急性缺血性中风患者入院到指定的中风中心和死亡率之间的关联.
- 评估中风中心对患者结局的影响,与非指定医院相比.
主要方法:
- 一项观察性研究利用了来自纽约全州规划和研究合作系统 (2005-2007) 的数据.
- 仪器变量分析,使用差异性医院距离,调整为比较中风中心和非指定医院之间的死亡率的医院前选择偏差.
- 死亡率在住院后的30天,1天,7天和1年被评估,并对胃肠道出血和急性心肌梗塞进行比较,以确保中风的特异性.
主要成果:
- 与非指定医院 (n=15,650) 相比,入院于指定中风中心的患者 (n=15,297) 显示30天全因死亡率在统计上显著降低 (10.1%对12.5%).
- 卒中中心的入院与使用血栓抑制剂治疗的更高发病率 (4.8%对1.7%) 有关.
- 这些结果的改善是针对中风患者的,因为胃肠道出血和急性心肌梗塞的死亡率在中风中心和非指定医院之间没有显著差异.
结论:
- 进入指定中风中心与急性缺血性中风患者的死亡率略微但显著降低有关.
- 脑卒中中心有助于更频繁地进行拯救生命的血栓解压疗法.
- 这些发现强调了专门的中风护理中心在提高急性缺血性中风的生存率方面所带来的好处.
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