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研究领域生物医学和临床科学心血管医学和血液学血液学
在急性缺血性中风患者中,血栓溶解门到针的时间与1年死亡率和再入院之间的关联

在急性缺血性中风患者中,血栓溶解门到针的时间与1年死亡率和再入院之间的关联

Shumei Man ¹, Ying Xian ², DaJuanicia N Holmes ², Roland A Matsouaka ^2,3, Jeffrey L Saver ⁴, Eric E Smith ⁵, Deepak L Bhatt ⁶, Lee H Schwamm ⁷, Gregg C Fonarow ⁸

Shumei Man ¹, Ying Xian ², DaJuanicia N Holmes ²

¹Department of Neurology and Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio.
²Duke Clinical Research Institute, Duke University, Durham, North Carolina.
³Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina.
⁴Department of Neurology, University of California, Los Angeles.
⁵Hotchkiss Brain Institute, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
⁶Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, Massachusetts.
⁷Comprehensive Stroke Center, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
⁸Division of Cardiology, University of California, Los Angeles.

⁰Department of Neurology and Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio.

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2020年六月3日

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在PubMed上查看摘要

概括

此摘要是机器生成的。

在65岁及以上的急性缺血性中风患者中,静脉注射组织等离子素激活剂 (tPA) 的门到针时间缩短与1年死亡率和再入院率的降低有关. 这些发现强调了快速进行血栓消毒治疗的重要性.

科学领域

神经学
心血管医学
公共卫生

背景情况

静脉内组织等离子体激活剂 (tPA) 是急性缺血性中风的关键治疗方法.
较早的tPA注射与更好的短期结果有关,但快速治疗的长期益处仍然不太清楚.

研究的目的

在老年急性缺血性中风患者中,对tPA的门到针时间缩短与长期结果之间的联系进行调查.
确定治疗时间缩短是否有助于提高1年死亡率和再入院率.

主要方法

对65岁以上的医疗保险受益者进行回顾性队列研究,治疗急性缺血性中风.
分析门到针的时间和1年的随访所有原因的死亡率和再入院率.
使用调整的危险比率 (HR) 进行统计分析,以比较基于门到针的时间间隔的结果.

主要成果

与在45分钟内接受治疗的患者相比,门到针时间> 45分钟的患者1年全因死亡率 (35. 0% vs 30. 8%) 和再入院率 (40. 8% vs 38. 4%) 显著增加.
较长的门到针时间 (> 60 分钟) 也与死亡率和再入院率的增加有关.
在抵达后90分钟内,每增加15分钟的门到针的时间,都与更高的死亡率 (HR,1. 04) 和再入院率 (HR,1. 02) 有关.

结论

在老年急性缺血性中风患者中,tPA的门到针时间较短与1年生存率的改善和再入院的减少有关.
这些发现强调了加快血栓治疗的临床重要性,以优化患者的长期治疗结果.
减少治疗延迟的努力对于提高tPA在急性缺血性中风治疗中的有效性至关重要.

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