在不同经济水平的国家中,中风后的实践模式和结果 (INTERSTROKE):一项国际观察研究
Peter Langhorne1, Martin J O'Donnell2, Siu Lim Chin3
1Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
Lancet (London, England)
|June 5, 2018
概括
低收入国家中风护理的可用性较低, 但获得中风病房和抗血小板治疗改善了患者的生存和康复. 改善这些地区的设施对于改善中风的结果至关重要.
科学领域:
- 全球健康
- 神经学
- 医疗服务研究
背景情况:
- 脑卒中对低收入和中等收入国家 (LMIC) 的影响是不成比例的.
- 与高收入国家 (HIC) 相比,LMIC中关于中风护理实践和结果的数据有限.
研究的目的:
- 将可用的中风护理模式与不同经济水平的国家患者的治疗结果进行比较.
- 无论国家收入如何, 确定影响中风恢复的因素.
主要方法:
- 从国际INTERSTROKE研究 (13,447名患者,142个地点,32个国家) 的数据分析.
- 用医院问卷来补充患者数据.
- 使用回归分析来评估服务,治疗和1个月患者结果 (死亡或依赖) 之间的关联.
主要成果:
- 与HIC患者相比,LMIC患者的中风较严重,脑内出血,服务获取较差,调查/治疗较少.
- 获得中风治疗单位改善了调查/治疗使用,康复和生存,没有严重的依赖 (OR 1.29).
- 使用急性抗血小板治疗与其他因素无关的改善生存率 (OR 1.39) 有关.
结论:
- 基于证据的中风护理,诊断和中风单位在LMIC中较少.
- 获得中风治疗和适当使用抗血小板药物与患者更好的康复相关.
- 改善中风护理设施和LMIC的准入对于改善患者的治疗结果至关重要.
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