急性缺血性脑卒中患者经皮机械取栓术后出院预后的预测因素:家庭出院组与医院转院组的比较

Keiichiro Aoki, Hisayoshi Suzuki, Takeaki Miyata, T. Ogino, Akihiro Iguchi
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引用次数: 0

摘要

目的:明确急性缺血性卒中和经皮机械取栓(PMT)后患者出院回家的预测因素。本研究纳入了2014年4月至2018年12月期间在A医院神经内科住院并接受PMT治疗的99例急性缺血性卒中患者。其中,32名和67名患者分别出院回家或到其他医院。从PMT后3天内的病历中回顾性收集以下项目:年龄;性;家庭同居和就业状况;血清白蛋白水平;意识障碍;美国国立卫生研究院卒中量表(NIHSS),在最严重时和术后24小时;上肢、手指、下肢Brunnstrom恢复期(BRS);口服;独立于日常生活活动,如吃饭、梳洗、如厕和行走;以及更严重的脑功能障碍。我们发现两组之间在意识障碍、NIHSS评分、BRS、口服摄入、饮食和打扮的独立性以及较高的脑功能障碍方面存在显著差异(p<0.05)。多元logistic回归分析显示:术后24小时NIHSS评分(优势比[OR]: 1.35;95%可信区间[CI]: 0.1520.448)和口服摄入(OR: 10.46, 95% CI: -2.252至-0.095)。术后24小时NIHSS评分和口服摄入量是急性缺血性脑卒中PMT后患者预后的有效预测指标。即使在卧床休息时间较低的情况下,也可以对这些情况进行评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predictors of discharge outcomes following percutaneous mechanical thrombectomy in patients with acute ischemic stroke: Comparisons between the home discharge group and hospital transfer group
To clarify predictors of outcomes that can indicate the appropriateness of discharging patients to their own homes following acute ischemic stroke and percutaneous mechanical thrombectomy (PMT). This study included 99 patients with acute ischemic stroke who were hospitalized in the Department of Neurology at Hospital A and underwent PMT between April 2014 and December 2018. Of these, 32 and 67 patients were discharged to their own homes or to other hospitals, respectively. The following items were retrospectively collected from medical records within 3 days of PMT: age ; sex ; familial cohabitation and employment status ; serum albumin level ; consciousness disorders ; National Institutes of Health Stroke Scale (NIHSS), at the most severe time and at 24 hours postoperatively ; Brunnstrom recovery stage (BRS) in upper limbs, fingers, and lower limbs ; oral intake ; independence in activities of daily living such as eating, grooming, toileting, and walking ; and higher brain dysfunction. We identified significant differences between the groups in terms of consciousness disorders, both NIHSS scores, BRS, oral intake, independence in eating and grooming, and higher brain dysfunction (p<0.05). Multiple logistic regression analysis revealed the following significant predictors of outcomes : NIHSS score at 24 hours postoperatively (odds ratio [OR]: 1.35 ; 95% confidence interval [CI]: 0.1520.448) and oral intake (OR : 10.46, 95% CI : -2.252 to -0.095). NIHSS score at 24 hours postoperatively and oral intake are useful predictors of patient outcomes following PMT for acute ischemic stroke. These can be assessed even when bed rest levels are low.
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