在接受内血管血栓切除术的大型缺血性中风患者的年龄和功能结果
Laurens Winkelmeier1, Helge Kniep1, Tobias Faizy2
1Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
JAMA network open
|August 12, 2024
概括
老年患者 (80岁以上) 接受内血管血栓切除术的大型缺血性中风的结果明显更差. 年龄会影响功能恢复和死亡率,但治疗决策应考虑个体患者的因素.
科学领域:
- 神经学 神经学
- 干预心脏病学 干预心脏病学
- 老年病的医生 老年病的医生
背景情况:
- 血管内血栓切除术对急性缺血性中风与大心脏病发作有效.
- 在临床试验中,老年人往往没有充分代表这种治疗方法.
研究的目的:
- 分析因大缺血性中风而接受内血管血栓切除术的患者基于年龄的功能结果.
主要方法:
- 来自德国中风登记处的408名患者的回顾性多中心队列研究 (2015年5月至2021年12月).
- 患有前部循环大血管封闭和大心脏病发作 (ASPECT 0-5) 的患者按年龄分层.
- 主要结局:90天独立行走 (mRS 0-3) 和死亡率 (mRS 6).
主要成果:
- 独立行走率从56.4% (≤60岁) 降至15.1% (>80岁).
- 死亡率从15.4% (≤60岁) 增加到64.3% (>80岁).
- 80岁以上与较低的行走率 (aOR 0.44) 和较高的死亡率 (aOR 2.75) 有关.
结论:
- 年龄显著影响大脑缺血性中风的内血管血栓切除术后的功能结果.
- 虽然老年患者 (>80) 预后较差,但固定的治疗年龄限制是不合理的.
- 结果帮助临床医生为老年中风患者做出明智的决策.
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