新闻对急性中风患者有价值吗?
Mariëlle K van Valburg1,2, Lisette M Vernooij1,3,4, Cornelis J Kalkman3
1Department of Intensive Care Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.
European stroke journal
|July 31, 2024
概括
在急性中风患者中,在住院前72小时内,国家早期预警分数 (NEWS) 达到5分或以上的生命不稳定性与死亡或依赖性有关. 意识障碍成为这种关联的主要驱动因素.
科学领域:
- 神经学 神经学
- 关键护理医学 关键护理医学
- 临床风险分层的临床风险分层
背景情况:
- 急性中风患者面临呼吸和循环系统损害的风险,导致生命不稳定.
- 国家早期预警分数 (NEWS) 是监测生命不稳定的常见工具.
- 评估生命不稳定性和急性中风90天结果之间的联系至关重要.
研究的目的:
- 评估生命不稳定性 (NEWS ≥5) 与中风后90天死亡或依赖之间的关联.
- 确定NEWS组件 (呼吸,循环,意识) 对中风结果的影响.
主要方法:
- 一项对763名患有缺血性中风,脑内出血 (ICH) 或脑下关节出血 (SAH) 的患者的观察队列研究.
- 在入院前72小时内,每8小时计算一次 NEWS.
- 普森回归被用来分析生命不稳定性和90天死亡或依赖性之间的关联 (修改的兰金度量得分≥3).
主要成果:
- 58-69%的中风患者至少经历过一次生命不稳定的事件.
- 生命不稳定与缺血性中风和SAH的死亡或依赖性增加有关.
- 意识障碍是主要的驱动因素,与所有类型中风的不良结果显著相关.
结论:
- 在因缺血性中风或SAH住院后的前72小时内,生命不稳定性预测90天的功能结果不佳.
- 意识受损是将生命不稳定与不良结果联系起来的关键因素.
- 目前的NEWS可能需要对急性中风患者进行修改,因为它的意识分类.
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