Adrian R Parry-Jones, Susann J Järhult, Natalie Kreitzer, Andrea Morotti, Danilo Toni, David Seiffge, Alexander David Mendelow, Hiren Patel, Hens Bart Brouwers, Catharina Jm Klijn, Thorsten Steiner, Walter Brian Gibler, Joshua N Goldstein
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引用次数: 0
摘要
目的：脑内出血 (ICH) 是最具破坏性的中风形式，也是致残的主要原因。个别疗法的临床试验未能明确确定一种特定的有益治疗方法。然而，引入护理捆绑的临床试验（同时提供多种疗法）似乎明显降低了发病率和死亡率。目前，没有足够的患者在急性期接受这些干预措施：我们召集了一个专家小组，讨论 ICH 的最佳实践，并为可在所有治疗急性 ICH 的环境中提供的捆绑式护理提出建议，重点关注欧洲的医疗保健系统：在这份共识文件中，我们主张在 ICH 中广泛实施正式的捆绑式护理，包括治疗时间的具体指标和考虑神经外科治疗的标准：对于这种毁灭性疾病来说，改善临床护理和临床治疗效果的机会非常难得。目前已经有大量证据表明，现在就可以而且应该实施一系列疗法。
Acute care bundles should be used for patients with intracerebral haemorrhage: An expert consensus statement.
Purpose: Intracerebral haemorrhage (ICH) is the most devastating form of stroke and a major cause of disability. Clinical trials of individual therapies have failed to definitively establish a specific beneficial treatment. However, clinical trials of introducing care bundles, with multiple therapies provided in parallel, appear to clearly reduce morbidity and mortality. Currently, not enough patients receive these interventions in the acute phase.
Methods: We convened an expert group to discuss best practices in ICH and to develop recommendations for bundled care that can be delivered in all settings that treat acute ICH, with a focus on European healthcare systems.
Findings: In this consensus paper, we argue for widespread implementation of formalised care bundles in ICH, including specific metrics for time to treatment and criteria for the consideration of neurosurgical therapy.
Discussion: There is an extraordinary opportunity to improve clinical care and clinical outcomes in this devastating disease. Substantial evidence already exists for a range of therapies that can and should be implemented now.
期刊介绍：
Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.
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