急性缺血性脑卒中机械取栓后90天预后的探索性描述性队列研究。

IF 1.2 4区 医学 Q3 NURSING
Contemporary Nurse Pub Date : 2022-08-01 Epub Date: 2022-09-19 DOI:10.1080/10376178.2022.2107038
Ling Feng, Yueyue He, Shuju Dong, Rui Wang, Shiyan Long, Li He
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引用次数: 1

摘要

目的:探讨急性缺血性脑卒中(AIS)患者机械取栓术后出院护理评估结果与预后的关系。方法:我们分析了2020年1月至2020年12月在中国四川省成都市某大学附属教学医院接受MT治疗的144例AIS患者的特征。使用改良Rankin量表(mRS)评分评估出院后90天的预后。采用IBM SPSS Statistics (Version 26.0)进行探索性分析。结果:90天时,47.9% (n = 69)患者预后良好(mRS≤2),其中22.2% (n = 32)患者完全康复。死亡5例(3.5%),预后差(mRS≥3)患者占48.6% (n = 70)。在单因素分析中,临床预后与出院时气管内插管(p = 0.02)、鼻胃管(p = 0.001)、留置导尿管(p = 0.001)、中心静脉导管(p = 0.03)、预防压力损伤健康知识需求(p = 0.03)、美国国立卫生研究院卒中量表(NIHSS)评分(p = 0.001)和日常生活活动(ADL)评分(p = 0.001)相关。144例患者平均住院时间为12[IQR, 9-25]天,平均住院费用为21291.93元(SD 9165.01)。结论:近半数存活患者预后较差。在我国,这种手术和康复造成了需要解决的重大经济负担。然而,较长的住院时间和较高的出院费用可能是导致较差结果的因素。综合护理评估的结果,包括护理需求、日常生活活动、神经功能,可以预测患者的预后。影响声明:我们建议在出院时进行全面的护理评估,以预测患者的预后,并可用于后续的针对性干预。急性缺血性脑卒中患者机械取栓后预后较差,需考虑经济负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
An exploratory descriptive cohort study of 90-day prognosis after acute ischaemic stroke with mechanical thrombectomy.

Aim: To evaluate the relationship between nursing assessment findings at discharge and acute ischaemic stroke (AIS) patient prognosis after mechanical thrombectomy (MT).

Methods: We analysed the characteristics of 144 AIS patients with MT treatment admitted to a university affiliated teaching hospital in Chengdu, Sichuan Province China, from January 2020 to December 2020. The modified Rankin Scale (mRS) score was used to assess outcomes 90-days after discharge. Exploratory analyses were undertaken using IBM SPSS Statistics (Version 26.0).

Results: At 90-days, 47.9% (n = 69) had a good prognosis (mRS ≤ 2) including 22.2% (n = 32) fully recovered patients. There were 5 (3.5%) deceased patients and 48.6% (n  = 70) of patients had a poor prognosis (mRS ≥ 3). In univariate analysis, clinical prognosis correlated with the need for inpatient endotracheal intubation (p = 0.02), nasogastric tube (p < 0.001), indwelling urinary catheter (p < 0.001), central venous catheter (p = 0.03), health knowledge needs of pressure injury prevention (p = 0.03), National Institute of Health Stroke Scale (NIHSS) score (p < 0.001) and Activities of Daily Living (ADL) score (p < 0.001) at the time of discharge from hospital. The average hospitalization time of the 144 patients was 12[IQR, 9-25] days, and the average cost of hospitalization was $Y$21291.93 (SD 9165.01).

Conclusion: Almost half of the surviving patients had a poor prognosis. In our country, this surgery and rehabilitation impose a significant financial burden that needs to be addressed. However, the longer length of hospital stay and higher costs at discharge may be contributing factors to worse outcomes. The outcomes of comprehensive nursing assessment of the patients, including nursing needs, activities of daily living, and neurological function, can predict their outcome.

Impact statement: We recommend a comprehensive nursing assessment at discharge that predicts patient outcomes and can be used for subsequent targeted interventions. The prognosis of patients with acute ischaemic stroke after mechanical thrombectomy is poor, and the financial burden needs to be considered.

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来源期刊
Contemporary Nurse
Contemporary Nurse 医学-护理
CiteScore
2.00
自引率
6.20%
发文量
38
审稿时长
6-12 weeks
期刊介绍: Contemporary Nurse is an international peer-reviewed journal designed to increase nursing skills, knowledge and communication, assist in professional development and to enhance educational standards by publishing stimulating, informative and useful articles on a range of issues influencing professional nursing research, teaching and practice. Contemporary Nurse is a forum for nursing educators, researchers and professionals who require high-quality, peer-reviewed research on emerging research fronts, perspectives and protocols, community and family health, cross-cultural research, recruitment, retention, education, training and practitioner perspectives. Contemporary Nurse publishes original research articles, reviews and discussion papers.
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