Early Thrombectomy Outcomes in Transfer Patients.
Early Thrombectomy Outcomes in Transfer Patients.
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DOI：
10.1016/j.amj.2020.12.007
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发表时间：
2021-03
影响因子：
--
通讯作者：
Sanelli PC
中科院分区：
文献类型：
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作者：
Boltyenkov AT;Wang JJ;Malhotra A;Katz JM;Martinez G;Sanelli PC
急性缺血性卒中（AIS）患者的最佳患者运输目的地仍不确定。本研究的目的是评估根据患者运输目的地确定卒中结局的预测变量。我们使用由2011年11月1日至2018年10月1日在我们机构接受血栓切除术的患者组成的急性缺血性卒中数据库进行了一项回顾性研究。共有171例患者被纳入统计分析; 42.1%（72/171）的患者在母船组（直接入院），57.9%（99/171）的患者在滴运组（转移）。多因素Logistic回归分析显示，驾驶距离是有利结局的预测因素（以英里表示）之间的患者的家和综合中风中心（CSC）（OR=0.95（0.90-0.99），p=0.035），无糖尿病（OR=3.60（1.20-10.82），p=0.022），入院时较低的美国国立卫生研究院卒中量表（NIHSS）评分（OR=0.91（0.85-0.97），p=0.003），症状发作至CSC到达时间更短（以小时表示）（OR=0.84（0.72-0.99），p=0.038）。我们的研究表明，患者家和CSC之间的驾驶距离较短，无糖尿病，NIHSS评分较低，以及从发病到到达医院的时间较短，对血管内治疗的AIS患者的结局产生了积极影响。
The optimal patient transportation destination of acute ischemic stroke (AIS) patients remains uncertain. The purpose of this study was to evaluate the predictive variables that determine stroke outcomes depending on the patient transportation destination. We performed a retrospective study using an acute ischemic stroke database consisting of patients, who underwent thrombectomy admitted to our institution from November 1, 2011 through October 1, 2018. A total of 171 patients were included in the statistical analysis; 42.1% (72/171) of patients were in the mothership group (directly admitted) and 57.9% (99/171) in the drip-and-ship group (transferred). Multivariable logistic regression revealed the predictive factors for favorable outcomes were driving distance (expressed in miles) between the patient’s home and a Comprehensive Stroke Center (CSC) (OR=0.95 (0.90–0.99), p=0.035), absence of diabetes mellitus (OR=3.60 (1.20–10.82), p=0.022), lower National Institutes of Health Stroke Scale (NIHSS) score at admission (OR=0.91 (0.85–0.97), p=0.003), and shorter symptom onset to CSC arrival time (expressed in hours) (OR=0.84 (0.72–0.99), p=0.038). Our study revealed that shorter driving distance between patient’s home and CSC, absence of diabetes, lower NIHSS score, and shorter onset to hospital arrival time positively impacted the outcomes of endovascularly treated AIS patients.