Analysis of 16,922 Patients with Acute Ischemic Stroke and Transient Ischemic Attack in Japan
Analysis of 16,922 Patients with Acute Ischemic Stroke and Transient Ischemic Attack in Japan
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日本 16,922 例急性缺血性中风和短暂性脑缺血发作患者分析
DOI：
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发表时间：
2004
影响因子：
2.9
通讯作者：
Takenori Yamaguchi
中科院分区：
文献类型：
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作者：
K. Kimura;S. Kazui;K. Minematsu;Takenori Yamaguchi
目的：本研究的目的是通过对日本全国156家医院进行的基于医院的前瞻性注册研究，阐明日本卒中医学的现状。研究方法：本研究纳入1999年5月至2000年4月期间在发病后7天内就诊的急性缺血性卒中和短暂性脑缺血发作（TIA）患者。一个共同的协议适用于每个参与医院。结果：共有16，922例患者（TIA，6.4%）入组本研究，平均年龄为70.6 ± 11.5岁（中位数71岁，范围18-107岁）。腔隙性卒中是最常见的卒中亚型（38.8%），其次是动脉粥样硬化性（33.3%）、心源性（21.8%）和其他卒中（6.1%）。入院时NIH卒中量表评分为8.0 ± 7.9（中位数5;第25至第75百分位数，2-11）。36.8%在发病后3 h内到达医院，49.5%在发病后6 h内到达医院。70.2%的患者在发病后3 h内到达医院，但只有29.9%的患者在发病后3 h后前往医院（p < 0.0001）。出院时改良兰金量表评分0-2分者占60.8%，评分3-5分者占32.3%，死亡率为6.9%。结论：超过一半的急性脑卒中患者在发病后6 h内到达医院。为了更好地管理卒中和改善患者结局，需要建立理想的急救系统，特别是在日本政府批准静脉注射重组组织型纤溶酶原激活剂治疗急性缺血性卒中后的未来。
Objective: The purpose of the present study was to clarify the present status of stroke medicine in Japan using a hospital-based, prospective registration study of 156 hospitals from all over Japan. Methods: Consecutive patients with acute ischemic stroke and transient ischemic attack (TIA) who presented to hospital within 7 days of onset from May 1999 to April 2000 were enrolled in this study. A common protocol was applied in every participating hospital. Results: A total of 16,922 patients (TIA, 6.4%) with a mean age of 70.6 ± 11.5 years (median 71 years, range 18–107 years) were enrolled in the study. Lacunar stroke was the most frequent stroke subtype (38.8%), followed by atherothrombotic (33.3%), cardioembolic (21.8%) and other stroke (6.1%). NIHstroke scale score on admission was 8.0 ± 7.9 (median 5; 25th to 75th percentile, 2–11). 36.8% arrived at hospital within 3 h of symptom onset, and 49.5% within 6 h. The ambulance was used for 70.2% of patients arriving within 3 h after onset, but in only 29.9% of patients visiting the hospital later than 3 h after onset (p < 0.0001). 60.8% displayed good outcome (modified Rankin Scale score of 0–2 at discharge), while 32.3% displayed poor outcome (score 3–5), and mortality rate was 6.9%. Conclusions: More than half of the acute stroke patients arrived at hospital later than 6 h after onset. Establishment of ideal emergency systems is needed for better management of stroke and for improvement of patient outcome, in particular, in the future after approval of intravenous recombinant tissue plasminogen activator for acute ischemic stroke by the Japanese government.
影响因子：
8.3
作者：
Petty, GW;Brown, RD;Wiebers, DO
通讯作者：
Wiebers, DO
影响因子：
8.3
作者：
Lin, HJ;Wolf, PA;DAgostino, RB
通讯作者：
DAgostino, RB