{"title":"伴有和不伴有活动性癌症的住院卒中患者的预后。","authors":"Hiroyuki Kawano, Ayumi Sakurai, Yuuki Takizawa, Risa Toyota, Reona Miwa, Hayate Onuki, Ayane Kawatake, Atsushi Yamamichi, Mikito Saito, Kaoru Nakanishi, Eisaku Tsuji, Shinya Tomari, Yuko Honda, Yoshiko Unno, Mayumi Uchida, Teruyuki Hirano","doi":"10.1007/s11239-025-03117-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Cancer is common in patients with ischemic stroke. The aim was to reveal the differences in acute management and outcomes of patients with in-hospital acute ischemic stroke (IHS) with and without active cancer.</p><p><strong>Methods: </strong>Two hundred IHS patients (58% male, median age 78 years, median NIHSS score 9) from August 2016 to July 2023 at our institution were divided into two groups: 70 with active cancer (IHS-AC 35%) and 130 without AC (IHS-nonAC 65%). Patients' characteristics, time intervals, and clinical outcomes were compared between the groups. A good clinical outcome was defined as modified Rankin Scale score 0-3.</p><p><strong>Results: </strong>IHS was identified most frequently by a nurse (IHS-AC group 67%, IHS-nonAC group 71%). Time from recognition to stroke physician assessment (37 vs. 90 min, p = 0.008) was shorter in the IHS-AC group. Good clinical outcomes at discharge (31% in each group, p = 1.000) and in-hospital mortality (IHS-AC group 29%, IHS-nonAC group 21%, p = 0.225) were similar in the groups. The rates of reperfusion therapy (intravenous rt-PA and/or mechanical thrombectomy) were 16% in the IHS-AC group and 15% in the IHS-nonAC group (p = 1.000). The rates of good clinical outcomes and mortality at discharge in patients with reperfusion therapy were each 36%.</p><p><strong>Discussion and conclusion: </strong>One-third of IHS patients had comorbid active cancer. The rates of reperfusion therapy and good clinical outcomes were similar in groups with and without active cancer. Acute stroke management should not be withheld solely based on cancer.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Outcomes of patients with in-hospital stroke with and without active cancer.\",\"authors\":\"Hiroyuki Kawano, Ayumi Sakurai, Yuuki Takizawa, Risa Toyota, Reona Miwa, Hayate Onuki, Ayane Kawatake, Atsushi Yamamichi, Mikito Saito, Kaoru Nakanishi, Eisaku Tsuji, Shinya Tomari, Yuko Honda, Yoshiko Unno, Mayumi Uchida, Teruyuki Hirano\",\"doi\":\"10.1007/s11239-025-03117-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Cancer is common in patients with ischemic stroke. The aim was to reveal the differences in acute management and outcomes of patients with in-hospital acute ischemic stroke (IHS) with and without active cancer.</p><p><strong>Methods: </strong>Two hundred IHS patients (58% male, median age 78 years, median NIHSS score 9) from August 2016 to July 2023 at our institution were divided into two groups: 70 with active cancer (IHS-AC 35%) and 130 without AC (IHS-nonAC 65%). Patients' characteristics, time intervals, and clinical outcomes were compared between the groups. A good clinical outcome was defined as modified Rankin Scale score 0-3.</p><p><strong>Results: </strong>IHS was identified most frequently by a nurse (IHS-AC group 67%, IHS-nonAC group 71%). Time from recognition to stroke physician assessment (37 vs. 90 min, p = 0.008) was shorter in the IHS-AC group. Good clinical outcomes at discharge (31% in each group, p = 1.000) and in-hospital mortality (IHS-AC group 29%, IHS-nonAC group 21%, p = 0.225) were similar in the groups. The rates of reperfusion therapy (intravenous rt-PA and/or mechanical thrombectomy) were 16% in the IHS-AC group and 15% in the IHS-nonAC group (p = 1.000). The rates of good clinical outcomes and mortality at discharge in patients with reperfusion therapy were each 36%.</p><p><strong>Discussion and conclusion: </strong>One-third of IHS patients had comorbid active cancer. The rates of reperfusion therapy and good clinical outcomes were similar in groups with and without active cancer. Acute stroke management should not be withheld solely based on cancer.</p>\",\"PeriodicalId\":17546,\"journal\":{\"name\":\"Journal of Thrombosis and Thrombolysis\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-05-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Thrombosis and Thrombolysis\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11239-025-03117-y\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Thrombosis and Thrombolysis","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11239-025-03117-y","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Outcomes of patients with in-hospital stroke with and without active cancer.
Background: Cancer is common in patients with ischemic stroke. The aim was to reveal the differences in acute management and outcomes of patients with in-hospital acute ischemic stroke (IHS) with and without active cancer.
Methods: Two hundred IHS patients (58% male, median age 78 years, median NIHSS score 9) from August 2016 to July 2023 at our institution were divided into two groups: 70 with active cancer (IHS-AC 35%) and 130 without AC (IHS-nonAC 65%). Patients' characteristics, time intervals, and clinical outcomes were compared between the groups. A good clinical outcome was defined as modified Rankin Scale score 0-3.
Results: IHS was identified most frequently by a nurse (IHS-AC group 67%, IHS-nonAC group 71%). Time from recognition to stroke physician assessment (37 vs. 90 min, p = 0.008) was shorter in the IHS-AC group. Good clinical outcomes at discharge (31% in each group, p = 1.000) and in-hospital mortality (IHS-AC group 29%, IHS-nonAC group 21%, p = 0.225) were similar in the groups. The rates of reperfusion therapy (intravenous rt-PA and/or mechanical thrombectomy) were 16% in the IHS-AC group and 15% in the IHS-nonAC group (p = 1.000). The rates of good clinical outcomes and mortality at discharge in patients with reperfusion therapy were each 36%.
Discussion and conclusion: One-third of IHS patients had comorbid active cancer. The rates of reperfusion therapy and good clinical outcomes were similar in groups with and without active cancer. Acute stroke management should not be withheld solely based on cancer.
期刊介绍：
The Journal of Thrombosis and Thrombolysis is a long-awaited resource for contemporary cardiologists, hematologists, vascular medicine specialists and clinician-scientists actively involved in treatment decisions and clinical investigation of thrombotic disorders involving the cardiovascular and cerebrovascular systems. The principal focus of the Journal centers on the pathobiology of thrombosis and vascular disorders and the use of anticoagulants, platelet antagonists, cell-based therapies and interventions in scientific investigation, clinical-translational research and patient care.
The Journal will publish original work which emphasizes the interface between fundamental scientific principles and clinical investigation, stimulating an interdisciplinary and scholarly dialogue in thrombosis and vascular science. Published works will also define platforms for translational research, drug development, clinical trials and patient-directed applications. The Journal of Thrombosis and Thrombolysis'' integrated format will expand the reader''s knowledge base and provide important insights for both the investigation and direct clinical application of the most rapidly growing fields in medicine-thrombosis and vascular science.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
