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血栓切除术医院间转移期间的临床变化:发生率,相关因素和与结果的关系
Pierre Seners1,2,3, Adrien Ter Schiphorst4, Anke Wouters1,5
1Stanford Stroke Center, Palo Alto, CA, USA.
概括
急性缺血性中风与大血管封闭 (LVO) 的医院间转移经常导致临床变化. 这些变化显著影响了3个月的结果,突出了改进转移治疗的需要.
科学领域:
- 神经学 神经学
- 血管神经学 血管神经学
- 脑卒中医学 脑卒中医学
背景情况:
- 患有急性缺血性中风和大血管封闭 (LVO) 的患者通常需要转移进行血栓切除术.
- 转移到非内血管有能力的中心需要医院间的先进护理运输.
研究的目的:
- 为了确定LVO中风的医院间转移期间显著临床变化的发生率.
- 确定转移期间与临床变化相关的因素.
- 分析临床变化与3个月功能结果之间的关系.
主要方法:
- 对两组急性中风患者进行血栓切除手术的分析 (斯坦福,美国;蒙彼利埃,法国).
- 纳入标准:参考医院的LVO证据和国家卫生研究院中风量表 (NIHSS) 记录的转移前和后的得分.
- 根据NIHSS得分变化,临床变化被分类为改善,恶化或稳定.
主要成果:
- 在504名患者中,64%的病情保持稳定,22%的病情有所改善,14%的病情在转移期间恶化.
- 与改善相关的因素包括静脉血栓溶解和远端闭塞;与近端闭塞和高葡萄糖相关的恶化.
- 临床改善与更好的3个月的结果相关 (aOR2.43),而恶化与更差的结果相关 (aOR0.60).
结论:
- 在LVO缺血性中风中,实质性的医院间临床变化是常见的.
- 这些临床变化显著影响患者在3个月后的功能结果.
- 开发治疗方法来改善转移期间的临床状况是有必要的.
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