Tokyo Metropolitan Stroke Emergency Medical Services for Interventional Stroke Treatment: The Tama-REgistry of Acute Thrombectomy (TREAT) Study
Tokyo Metropolitan Stroke Emergency Medical Services for Interventional Stroke Treatment: The Tama-REgistry of Acute Thrombectomy (TREAT) Study
复制标题
东京都中风介入治疗紧急医疗服务：急性血栓切除术 (TREAT) 研究的多摩注册
DOI：
10.1016/j.jstrokecerebrovasdis.2020.104752
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发表时间：
2020
影响因子：
2.5
通讯作者：
Hirano Teruyuki
中科院分区：
文献类型：
--
作者：
Abe Arata;Ota Takahiro;Ueda Masayuki;Amano Tatsuo;Shigeta Keigo;Matsumaru Yuji;Shiokawa Yoshiaki;Hirano Teruyuki
目的大血管闭塞(LVO)患者机械血栓摘除术(MT)后是如何通过急救送往医院的，目前尚不清楚。我们描述了一个大城市卒中传递系统的现状。方法我们调查了2015年1月至2017年12月在东京多摩地区12家机构接受MT的328例患者的数据，其中男性 = 患者199例，平均年龄(74.8±12.9)岁。根据目的地机构将患者分类为符合卒中条件的A组(A组，n = 266[8.2%])、三级重症监护中心(T组；n = 35[10.7%])和其他目的地，如急诊室(O组；结果A组轻度卒中和大脑中动脉闭塞率显著高于T组，椎基底动脉闭塞率显著低于T组和O组。A组从入院到出院的时间显著低于T组和O组。A组从发病到再通的时间显著低于T组和O组。结果A组的轻度卒中和大脑中动脉闭塞的发生率显著高于T组，而椎基底动脉闭塞的发生率则显著低于T组和O组。A组从发病到再通的时间显著低于 = 组。再通成功率和预后良好(90天改良Rankin评分0~2分)，无论目的地如何，差异均无统计学意义。结论TAMA区LVO患者大多被归入A组，DTP明显低于A组。
ObjectiveIt is not clear how patients with large vessel occlusion (LVO) who have undergone mechanical thrombectomy (MT) were transported to hospitals by emergency medical services. Here, we describe the current status of the stroke delivery system in a large city.MethodsWe investigated data from 328 patients (male, n = 199; average age, 74.8 ± 12.9 years) who underwent MT at 12 facilities in the Tama area of Tokyo, between January 2015 and December 2017. The patients were classified according to the destination institution as Stroke A eligible (group A, n = 266 [8.2%]), Tertiary critical care center (group T; n = 35 [10.7%]), and other destinations such as emergency rooms (group O; n = 27 [8.2%]), and then reasons for using Emergency Medical Service (EMS) services and outcomes were compared among the groups.ResultsRates of milder stroke, and middle cerebral artery occlusion were significantly higher in group A than T, whereas that of vertebral-basilar artery occlusion was significantly lower in group A than in groups T and O. The amount of elapsed time from door to picture (DTP) was significantly lower in group A. The time from onset to recanalization, as well as rates of successful recanalization and favorable outcomes (90-day modified Rankin scale 0-2) did not significantly differ regardless of destination.ConclusionsMost patients with LVO in the Tama area were categorized into group A. DTP was significantly lower in group A.