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在参与前性MonDAFIS研究的德国认证中风病房进行例行诊断心脏工作的程度
Manuel C Olma1,2, Serdar Tütüncü1,3, Ulrike Grittner4
1Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Neurological research and practice
|May 31, 2023
概括
对于中风患者的心脏诊断工作在德国中风中心有很大的差异. 根据医院类型,心声学和霍尔特心电图的使用有所不同,这影响了心房的检测和中风护理的标准化.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 公共卫生 公共卫生
背景情况:
- 心血管栓塞占缺血性中风的25%,通常与心房动 (AF) 相关.
- 关于德国中风病房心脏诊断工作标准化的数据有限.
研究的目的:
- 分析德国认证中风病房的常规心脏诊断工作的程度和标准化.
- 将不同级别的中风中心的诊断实践进行比较:基于大学的综合性中风中心 (UCSC),非大学综合性中风中心 (nUCSC) 和初级中风中心 (PCS).
主要方法:
- 蒙达菲斯研究包括3431名非AF患者,在38个德国中风单位中患有急性缺血性中风或TIA.
- 分析了常规诊断工作,包括24小时的霍尔特心电图和心声回声图 (TEE/TTE),但不包括研究特定的监测.
- 多变量混合回归分析比较了UCSC,nUCSC和PCS的诊断率和中风单位停留时间.
主要成果:
- 与TIA相比,严重中风和缺血性中风的中风单位停留时间更长.
- 24小时的霍尔特电图监测有显著的差异:47%的UCSC,71%的nUCSC和84%的PCS.
- 心声扫描率也各不相同,PCS执行最频繁 (90.3%),而AF检测在UCSC和nUCSC较PCS低.
结论:
- 常规心声回声和霍尔特心电图在中风病房中的使用显示出基于认证等级和大学附属的相当大的差异.
- 这些发现凸显了德国中风患者心脏诊断工作中缺乏标准化的情况.
- 需要进一步的研究来优化诊断协议,并改善中风护理的一致性.
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