患者报告的脑静脉血栓与缺血性脑卒中的预后比较

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-05-20 DOI:10.1016/j.jstrokecerebrovasdis.2025.108354

Hyunjun Ahn BS , Yadi Li MEd , Brittany Lapin PhD, MPH , Maximos McCune BA , Irene Katzan MD, MS

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引用次数: 0

摘要

目的脑静脉血栓形成（CVT）和缺血性脑卒中均涉及脑血管血流中断，但两者在病理生理、临床特征和预后方面存在差异。本研究比较了CVT和缺血性脑卒中患者报告的预后（PROs）及其随时间的变化轨迹。方法本回顾性队列研究纳入2019年1月至2024年4月期间在脑血管诊所完成至少一项以下PRO的CVT或缺血性卒中住院患者：患者健康问卷-9、PROMIS全球健康、neuroqol认知功能和PROMIS疼痛干扰、身体功能、社会角色满意度、疲劳、自我效能感和睡眠障碍量表。采用倾向性评分将CVT患者与缺血性脑卒中患者进行1:3的匹配。使用混合效应模型对不同时间的PROs进行比较。结果72例CVT和2533例缺血性脑卒中患者中，匹配后纳入CVT 69例和缺血性脑卒中196例（平均年龄47.5±17.0岁，女性62.6%，修正Rankin评分中位数为1）。脑组织损伤发生率为30.6%。两组均表现出相当的PROs，但CVT患者报告的疼痛干扰更严重，与缺血性卒中患者相比，随着时间的推移，PROMIS全球心理健康和与健康相关的生活质量也在恶化。结论：尽管CVT患者的功能预后良好，脑损伤发生率较低，但与基线特征相似的缺血性脑卒中患者相比，CVT患者在严重程度和模式上的PROs更差或相似。传统的临床评估可能无法完全捕捉CVT的影响，除了血管病理学外，更广泛的结果的整体护理方法可能是有益的。

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Patient reported outcomes of cerebral venous thrombosis compared to ischemic stroke

Purpose

Although both cerebral venous thrombosis (CVT) and ischemic stroke involve cerebrovascular flow disruption, they differ in pathophysiology, clinical features, and outcomes. This study compared patient-reported outcomes (PROs) and their trajectories over time between CVT and ischemic stroke patients.

Methods

This retrospective cohort study included patients hospitalized for CVT or ischemic stroke who completed at least one of the following PRO in cerebrovascular clinic between January 2019 and April 2024: Patient Health Questionnaire-9, PROMIS Global Health, Neuro-QoL cognitive function, and PROMIS scales for pain interference, physical function, social role satisfaction, fatigue, self-efficacy and sleep disturbance. CVT patients were matched (1:3) with ischemic stroke patients by propensity scores. PROs were compared over time using mixed-effects models.

Results

Of 72 CVT and 2,533 ischemic stroke patients, 69 CVT and 196 ischemic stroke patients were included after matching (average age 47.5 ± 17.0 years, 62.6% female, median modified Rankin score 1). Brain tissue injury occurred in 30.6% of CVT patients. Both groups exhibited comparable PROs, but CVT patients reported worse pain interference, and worsening PROMIS global mental health and health-related quality of life over time compared to ischemic stroke patients.

Conclusions

Despite favorable functional outcomes and lower rates of brain injury, CVT patients had worse or comparable PROs in severity and patterns compared to the subset of ischemic stroke patients with similar baseline characteristics. Traditional clinical assessments may not fully capture the impact of CVT, and a holistic care approach addressing broader spectrum of outcomes, in addition to vascular pathology, could be beneficial.

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.