在三级 unit 中进行心血管自主测试后,不明原因的确定的病因学
Parisa Torabi1,2, Viktor Hamrefors1,3, Richard Sutton1,4
1Department of Clinical Sciences, Lund University, Malmö, Sweden.
概括
心血管自主测试 (CATs) 在79%的患者中诊断出昏睡. CAT后无法解释的昏迷与年龄较大,没有前兆和心血管问题有关,这表明需要进一步调查.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 内部医学 内部医学
背景情况:
- 昏迷是一种常见的疾病,原因多种多样,需要准确的诊断.
- 专门的昏迷单位使用心血管自主测试 (CATs) 提高了诊断产量.
- 在接受CAT的患者中,多达21%的患者有不确定的结果,这给诊断带来了挑战.
研究的目的:
- 调查CAT后无法解释的昏迷的预测因素.
- 为了表征具有不确定的CAT结果的患者.
- 确定与CATs未能诊断的病因学诊断相关的临床发现.
主要方法:
- 对连续昏迷患者 (n=2663) 的分析,在昏迷单位进行评估.
- 应用心血管自主测试 (CATs),包括头向上倾斜测试.
- 统计分析以确定阴性CAT结果的预测因素.
主要成果:
- 在79%的患者中,CATs确定了昏睡的原因.
- 不确定的CAT结果的预测因素包括年龄较大,卧式心率较高,没有前发症,高血压,糖尿病,心力衰竭和冠状动脉疾病.
- 在CAT后患有不明原因昏迷的患者年龄较大,与血管性昏迷患者相比,患有更多的心血管并发症.
结论:
- 心血管自主测试对大多数患者的昏迷诊断有效.
- 缺少前发症和心血管并发症的存在预测了CATs无法确定昏迷病因的失败.
- 由于潜在的心脏风险,具有不确定的CAT结果的患者需要进一步调查.
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