在没有手术干预的无症状严重关节狭窄症患者中缺血性中风的发生率
Robert W Chang1,2, Lue-Yen Tucker2, Kara A Rothenberg3
1Department of Vascular Surgery, The Permanente Medical Group, South San Francisco, California.
JAMA
|May 24, 2022
概括
在5年内,医疗治疗的无症状重症缩患者中,中风发生率为4. 7%. 这项研究提供了关于无症状动脉狭窄症治疗中风结果的数据.
科学领域:
- 神经学
- 血管外科
- 公共卫生
背景情况:
- 由于医疗治疗的发展和有限的当代比较数据,对无症状的严重喉狭窄的最佳治疗仍然不清楚.
- 医疗保健的进步需要对未接受手术的患者中风风险的最新证据.
研究的目的:
- 估计无症状的严重动脉狭窄症患者的中风预后,而无需手术治疗.
- 提供有关动脉疾病治疗选择的最新数据.
主要方法:
- 在2008年至2012年期间诊断出70%至99%无症状的成年患者的回顾性队列研究.
- 在美国大型综合医疗系统内延长至2019年,不包括最近的神经事件或之前的干预.
- 主要结局是与动脉相关的急性缺血性中风,对死亡,退学或干预进行审查.
主要成果:
- 这项研究包括2314名从未接受干预的患者 (2539名动脉患者),平均随访时间为4. 1年.
- 在干预之前,平均每年中风率为0. 9% (95% CI,0. 7%- 1. 2%).
- 5 年的卡普兰- 梅尔估计结果为 4. 7% (95% CI,3. 9% - 5. 7%).
结论:
- 在社区队列中,在5年内接受医疗治疗的无症状重度动脉狭窄症患者的斜侧脑卒中发生率为4. 7%.
- 这些发现为临床决策提供了关键的见解,涉及无症状严重动脉狭窄的手术与医疗治疗.
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