IF 2.7 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Jørgen Ibsen, Maren Ranhoff Hov, Torunn Varmdal, Christian Georg Lund, Christian Hall
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引用次数: 0

摘要

背景:脑卒中的快速诊断和治疗对良好的预后非常重要。在某些情况下,缺血性中风患者到达医院时已来不及进行再灌注治疗。尤其是在农村地区,运送过程中花费的时间可能会延误甚至排除到达医院后的溶栓治疗。我们的目的是估计这一问题在挪威人口中的严重程度和临床相关性:我们收集了 2017 年和 2018 年所有报告的急性缺血性脑卒中数据。根据地理数据计算了从家到医院的交通时间,并将其与溶栓、血栓切除术的频率和3个月后的临床结果联系起来:随着转运时间的增加,再灌注治疗的频率明显下降。在 9 428 名患者中,6%(564 人)被归类为转运时间过长。在这组患者中,静脉溶栓治疗的频率为 10.5%,而在未出现转运时间过长的情况下则为 28.2%。两组中分别有 2.1% 和 4.9% 的患者进行了血栓切除术。根据修改后的兰金量表判断,我们没有发现两组在临床结果方面存在显著的统计学差异:在2017年和2018年,相对较少的一组挪威患者因转运时间较长而不适合接受缺血性中风再灌注治疗。在这种情况下,院前诊断和治疗解决方案可能会改善急性中风治疗的可及性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Transport time as a potential limiting factor for thrombolytic treatment of stroke in Norway.

Background: Rapid diagnosis and treatment of stroke is important for good outcome. In some cases, patients with ischemic stroke arrive at hospital too late for reperfusion therapy. This may be the case especially in rural areas where time spent during transport may delay or even preclude thrombolytic treatment after hospital arrival. We aimed to estimate the extent and clinical relevance of this problem in the Norwegian population.

Methods: We collected data for all reported acute ischemic strokes for the years 2017 and 2018. Transport times from home to hospital were calculated from geographical data and related to frequency of thrombolysis, thrombectomy and clinical outcome after 3 months.

Results: The frequency of reperfusion therapy decreased significantly as transport time increased. Six percent (564) of 9 428 patients were classified as having a prolonged time in transport. In this group, frequency of intravenous thrombolysis was 10,5% as opposed to 28,2% when prolonged transport was not present. Thrombectomy was performed in 2.1% versus 4.9% in the two groups respectively. We did not find a statistically significant difference between the two groups with regard to clinical outcome as judged by the modified Rankin Scale.

Conclusion: In the years 2017 and 2018 a relatively small group of Norwegian patients with prolonged time in transport was disfavored concerning access to reperfusion therapy for ischemic stroke. In such cases a prehospital solution for diagnostic work up and treatment might improve access to acute stroke treatment.

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来源期刊
BMC Health Services Research
BMC Health Services Research 医学-卫生保健
CiteScore
4.40
自引率
7.10%
发文量
1372
审稿时长
6 months
期刊介绍: BMC Health Services Research is an open access, peer-reviewed journal that considers articles on all aspects of health services research, including delivery of care, management of health services, assessment of healthcare needs, measurement of outcomes, allocation of healthcare resources, evaluation of different health markets and health services organizations, international comparative analysis of health systems, health economics and the impact of health policies and regulations.
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