Practice patterns for neuroimaging and transfusion therapy for management of neurologic complications in sickle cell anemia: DISPLACE consortium.
Practice patterns for neuroimaging and transfusion therapy for management of neurologic complications in sickle cell anemia: DISPLACE consortium.
复制标题
DOI：
10.1002/pbc.28569
复制
发表时间：
2020-11
影响因子：
3.2
通讯作者：
(on behalf of the DISPLACE investigators)
中科院分区：
文献类型：
--
作者：
Phillips S;Schlenz AM;Mueller M;Melvin C;Adams RJ;Kanter J;(on behalf of the DISPLACE investigators)
患有镰状细胞性贫血（SCA）的儿童有神经系统并发症（中风和无症状脑梗死）的风险。2014年国家心肺血液研究所（NHLBI）镰状细胞病指南包括对有缺血性卒中风险或患有缺血性卒中的SCA儿童启动和维持慢性红细胞输注（CRCT）治疗的建议。该指南不包括脑成像用于卒中筛查的明确建议。本研究的目的是评估目前的中风风险筛查，预防和干预措施之间的传播和实施中风预防看护理环境（DISPLACE）研究地点。对DISPLACE研究中心的主要研究者进行了一项调查，以确定与STOP研究方案和2014年NHLBI指南相关的当前卒中预防实践。使用描述性统计和逐行评论分析数据。临床试验机构一致采用NHLBI建议，针对缺血性卒中和经颅多普勒超声（TCD）结果异常启动CRCT。同样，几乎所有临床试验机构报告在TCD结果异常后获得MRI/MRA。MRI/MRA的其他适应症、MRI/MRA的频率和启动CRCT的其他神经系统适应症存在广泛差异。通过TCD和CRCT启动预防缺血性卒中的基于指南的实践在几乎所有研究中心都很明显。与MRI/MRA相关的实践存在很大差异，可能受到最近卒中预防试验的影响。美国血液学会的新指南于2020年4月发布，这可能会减少实践差异。
Children with sickle cell anemia (SCA) are at risk for neurologic complications (stroke and silent cerebral infarct). The 2014 National Heart, Lung, and Blood Institute (NHLBI) guidelines for sickle cell disease include recommendations for initiation and maintenance of chronic red cell transfusion (CRCT) therapy for children with SCA at risk for or with ischemic stroke. The guidelines do not include well-delineated recommendations for cerebral imaging for stroke screening. The purpose of this study was to evaluate current stroke risk screening, prevention, and intervention practices amongst the Dissemination and Implementation of Stroke Prevention Looking at the Care Environment (DISPLACE) study sites. A survey was administered to DISPLACE site Principal Investigators to identify current stroke prevention practices relative to the STOP study protocols and the 2014 NHLBI guidelines. Data were analyzed using descriptive statistics and line-by-line analysis of comments. Sites consistently applied NHLBI recommendations to initiate CRCT for ischemic stroke and abnormal transcranial Doppler ultrasound (TCD) results. Similarly, nearly all sites reported obtaining an MRI/MRA following an abnormal TCD result. There was wide variation for other indications for MRI/MRA, frequency of MRI/MRA, and other neurological indications for initiating CRCT. Guideline-based practices for preventing ischemic stroke through TCD and CRCT initiation were evident in nearly all sites. Wide variation in practices pertaining to MRI/MRA exist, potentially influenced by more recent stroke prevention trials. New guidelines from the American Society of Hematology were published in April 2020, which may reduce practice variation.
登录
查看更多内容
DOI：
10.1016/s0140-6736(15)01041-7
发表时间：
2016-02-13
期刊：
Lancet (London, England)
影响因子：
--
作者：
Ware RE;Davis BR;Schultz WH;Brown RC;Aygun B;Sarnaik S;Odame I;Fuh B;George A;Owen W;Luchtman-Jones L;Rogers ZR;Hilliard L;Gauger C;Piccone C;Lee MT;Kwiatkowski JL;Jackson S;Miller ST;Roberts C;Heeney MM;Kalfa TA;Nelson S;Imran H;Nottage K;Alvarez O;Rhodes M;Thompson AA;Rothman JA;Helton KJ;Roberts D;Coleman J;Bonner MJ;Kutlar A;Patel N;Wood J;Piller L;Wei P;Luden J;Mortier NA;Stuber SE;Luban NLC;Cohen AR;Pressel S;Adams RJ
通讯作者：
Adams RJ
影响因子：
7.5
作者：
Chou, Stella T.;Alsawas, Mouaz;Akl, Elie A.
通讯作者：
Akl, Elie A.
影响因子：
1.2
作者：
Madden, Nicholas A.;Jones, Gary L.;Woods, Gerald
通讯作者：
Woods, Gerald
影响因子：
3.2
作者：
Schlenz, Alyssa M.;Phillips, Shannon;Kanter, Julie
通讯作者：
Kanter, Julie
影响因子：
4.5
作者：
Harris PA;Taylor R;Thielke R;Payne J;Gonzalez N;Conde JG
通讯作者：
Conde JG