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从穿孔到再通道的时间对中风后处置和相关成本的影响
Akash Agrawal1, Arjun Agrawal1, Jase Howell1
1Department of Neurological Surgery Goodman Campbell Brain and Spine Carmel IN USA.
Stroke (Hoboken, N.J.)
|January 29, 2026
概括
对中风血栓切除术的更长的程序时间增加了死亡或临终关怀的风险,并增加了医疗保健成本. 减少手术时间对于改善患者的治疗结果和节省成本至关重要.
科学领域:
- 神经学 神经学
- 干预性放射学 干预性放射学
- 卫生经济学 卫生经济学
背景情况:
- 在中风血栓切除术后,医院后立即的患者处置和经济影响尚未得到充分研究.
- 现有的文献主要集中在长期结果上,忽视了急性护理的影响.
- 本研究通过检查程序时间对急性处置和成本的影响来弥补这一差距.
研究的目的:
- 调查中风血栓切除术期间的手术时间与急性医院后处置之间的关系.
- 分析与手术时间延迟相关的急性护理直接成本.
- 量化延长手术时间对中风护理的经济影响.
主要方法:
- 对721名经过血栓切除术的患者 (2011-2020年) 的回顾性分析.
- 关键指标:处置 (康复,家庭,死亡/临终关怀,长期护理) 和从大腿穿刺到再通道 (PTR) 的时间.
- 使用多项逻辑回归和成本分析,并根据临床因素进行调整.
主要成果:
- 每增加15分钟的PTR都与更高的死亡/临终关怀几率显著相关 (OR:1.020,P=0.001).
- 延误使死亡/临终关怀的可能性增加了2至4.6%,家庭处置减少了1.5至2.5%.
- 每次15分钟的PTR延迟每次中风发作增加了大约190美元的直接急性护理费用.
结论:
- 在中风血栓切除术中,延长的手术时间 (PTR) 与患者不良情绪 (增加死亡/临终关怀) 相对相关.
- 较长的PTR显著增加了每次中风事件的直接急性护理成本.
- 在全国范围内,每15分钟的PTR延迟每年可能造成7.2至770万美元的中风相关医疗费用.
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