脑静脉血栓症的延迟诊断:相关因素和临床结果
Ekaterina Bakradze1, Liqi Shu2, Nils Henninger3,4
1Department of Neurology University of Alabama at Birmingham Birmingham AL USA.
Journal of the American Heart Association
|September 27, 2023
概括
晚期脑静脉血栓 (CVT) 诊断,通常超过10天,发生在23%的患者中. 孤立的头痛是关键因素,但延迟诊断没有影响长期结果.
科学领域:
- 神经学 神经学
- 血管医学 血管医学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 识别导致脑静脉血栓症 (CVT) 延迟诊断的因素对于开发有效的早期检测策略至关重要.
- 很大一部分CVT病例会出现诊断延迟,这可能会影响患者的治疗和结果.
研究的目的:
- 确定与脑静脉血栓症 (CVT) 患者延迟诊断相关的临床因素.
- 评估延迟CVT诊断对临床结果的影响,包括功能状态和再道化.
主要方法:
- 使用ACTION-CVT研究数据进行了一项回顾性队列研究.
- 包括具有可用的神经症状发病日期和CVT诊断日期的参与者 (N=935).
- 延迟诊断被定义为从症状发作 (>10天) 的第四季度的诊断. 使用后勤回归来识别相关因素并评估结果关联.
主要成果:
- 从症状发作到CVT诊断的中位时间为4天,23%的患者经历了延迟诊断 (>10天).
- 与延迟诊断相关的因素包括孤立的头痛 (aOR,2.36),年龄较大 (aOR,1.02) 和乳头 (aOR,2.00).
- 较高的国家卫生研究院中风量表得分与诊断延迟相反相关 (aOR,0.95). 延迟诊断与修改的兰金尺度得分在90天内≤1没有显著的关联 (aOR,1.08).
结论:
- 在这个大型多中心队列中,大约四分之一的患者面临CVT的延迟诊断,超过症状出现后10天.
- 孤立的头痛成为CVT诊断延迟的重要预测因素.
- 推迟CVT诊断没有发现与不良临床结果相关,例如长期功能障碍.
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