Ischemic stroke mortality and time for hospital arrival: analysis of the first 90 days.

IF 1.2 4区医学 Q3 NURSING

Revista da Escola de Enfermagem da U S P Pub Date : 2023-01-01 DOI:10.1590/1980-220X-REEUSP-2022-0309en

Mariana de Almeida Moraes, Pedro Antônio Pereira de Jesus, Ludimila Santos Muniz, Greice Alves Costa, Larissa Vitória Pereira, Letícia Melquiades Nascimento, Carlos Antônio de Souza Teles, Camila Antunes Baccin, Fernanda Carneiro Mussi

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引用次数: 2

Abstract

Objective: To analyze the association between time of arrival at a reference hospital and mortality of people with ischemic stroke.

Method: Descriptive and inferential statistics were used. Modifying and confounding variables between time of arrival and mortality were observed in the multivariate analysis. The Akaike Information Criterion was used to choose the model. Statistical significance of 5% and risk correction using the Poisson Model were adopted.

Results: Most participants arrived within 4.5 hours of symptom onset or wake up stroke to the referral hospital and 19.4% died. The score of the National Institute of Health Stroke Scale was a modifier. In the multivariate model stratified by scale score ≥14, arrival time >4.5h was associated with lower mortality; and age ≥60 years and having Atrial Fibrillation, to higher mortality. In the model stratified by score ≤13, previous Rankin ≥3, and presence of atrial fibrillation were predictors of mortality.

Conclusion: The relationship between time of arrival and mortality up to 90 days was modified by the National Institute of Health Stroke Scale. Prior Rankin ≥3, atrial fibrillation, time to arrival ≤4.5h, and age ≥60 years contributed to higher mortality.

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缺血性卒中死亡率和到达医院时间:前90天的分析。

目的:分析缺血性脑卒中患者到达参考医院时间与死亡率的关系。方法:采用描述统计和推理统计相结合的方法。在多变量分析中观察到到达时间和死亡率之间的修正变量和混淆变量。采用赤池信息准则选择模型。统计学显著性为5%，采用泊松模型进行风险校正。结果:大多数参与者在症状发作或卒中苏醒后4.5小时内到达转诊医院，19.4%死亡。美国国立卫生研究院卒中量表的得分是一个修正因子。在量表评分≥14分分层的多变量模型中，到达时间>4.5h与较低的死亡率相关;年龄≥60岁且有房颤者，死亡率较高。在评分≤13分分层的模型中，先前的Rankin≥3和房颤的存在是死亡率的预测因子。结论:美国国立卫生研究院卒中量表修正了90天内到达时间与死亡率之间的关系。既往Rankin≥3、房颤、到达时间≤4.5h、年龄≥60岁是死亡率较高的原因。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista da Escola de Enfermagem da U S P 医学-护理

CiteScore

1.70

自引率

11.10%

发文量

254

审稿时长

3-8 weeks

期刊介绍： The University of São Paulo Nursing School Journal (Revista da Escola de Enfermagem da USP, REEUSP) is a bimonthly periodical revised by fellow nurses, which has the objective of publishing empirical or theoretical articles that represent a significant advance for the professional practice or for the fundaments of Nursing Mission: to stimulate knowledge production and dissemination in Nursing and related areas, focusing on international interlocution to advance Nursing science. Areas of Interest: Nursing and Health Its abbreviated title is Rev Esc Enferm USP, which should be used in bibliographies, footnotes and bibliographical references and strips.