在增加社区医院内血管中风能力后,缺血性中风入院的系统水平趋势
Prateek Kumar1, Sergio Salazar-Marioni1, Saagar Dhanjani2
1Department of Neurology, McGovern Medical School at UTHealth, Houston, Texas, USA.
Journal of neurointerventional surgery
|August 30, 2024
概括
社区医院升级为内血管中风治疗 (EST) 执行医院 (EPH) 状态的社区医院,急性缺血性中风 (AIS) 病例每月增加2%. 已建立的EPH在过渡后经历了AIS体积和治疗量的下降.
科学领域:
- 神经学 神经学
- 血管外科 血管外科
- 医疗保健管理的管理
背景情况:
- 越来越多的人对将内血管中风治疗 (EST) 能力扩展到社区医院越来越感兴趣.
- 评估过渡到一家执行EST的医院 (EPH) 对急性缺血性中风 (AIS) 住院的影响. 在一个混合的学术和社区医院系统中.
研究的目的:
- 评估社区医院获得EST能力对AIS入院趋势的影响.
- 分析EPH过渡后中风类型 (LVO与非LVO) 和治疗利用率 (tPA,EST) 的变化.
主要方法:
- 从2014年1月至2022年12月期间从10家医院 (1个EPH,3个过渡EPH,6个非EPH) 收集的前性数据的分析.
- 对比不同医院组的AIS入院趋势,中风亚型和EPH过渡前后治疗率.
- 利用一个多机构的注册表来收集20317个AIS入学数据.
主要成果:
- 过渡到EPH状态的医院 (B组) 在过渡后的第一年经历了AIS入院的每月增长1.9%,非LVO AIS的每月增长4.2%.
- 已建立的EPH (A组) 在过渡期后显示AIS入院,LVO/非LVO AIS以及EST和tPA治疗的显著下降.
- 患者的中位数年龄为67岁,52.4%是男性,NIHSS中位数为4.
结论:
- 升级到EPH身份与转型医院在第一年增加AIS入院相关.
- 已建立的EPH可能会经历患者数量和治疗率的减少,这是由于其系统中EST访问的扩展.
- 调查结果强调了在社区环境中增加内血管中风护理的系统范围的影响.
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