Need For And Clinical Effectiveness Of A Neurologist Supervised, Nurse Case Managed Stroke Risk Reduction Program
Need For And Clinical Effectiveness Of A Neurologist Supervised, Nurse Case Managed Stroke Risk Reduction Program
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神经科医生监督、护士病例管理的中风风险降低计划的需求和临床有效性
作者：
E. F. Lafranchise;Wallette G Widener;B. Franklin;R. Salmon;R. Leighton;C. D. English;N. Gordon
P157页
既往有过中风或短暂性脑缺血发作的患者以及那些有颈动脉疾病的患者首次或复发中风的风险更高。在这项研究中，我们调查了在一家私人神经科诊所的247名连续患者中潜在可改变的心血管危险因素的患病率，这些患者以前患有中风或短暂性脑缺血发作和/或有记录的颈动脉疾病。我们还评估了这些患者在12周(n=125)和1年(n=36)参与神经科医生监督、护士病例管理的卒中风险降低计划的临床效果。在基线水平，潜在的可改变的心血管疾病危险因素包括体力活动不足(68%的患者)、收缩压升高(54%的患者)、低密度脂蛋白胆固醇(46%的患者)、肥胖(36%的患者)、舒张压升高(32%的患者)和吸烟(15%的患者)。在完成12周和1年的计划参与后，在基线值异常的患者中，选择的心血管危险因素的临床相关改善被观察到(表)。这些数据表明，在卒中高危患者中，潜在的可改变的心血管危险因素通常是次优控制的。我们的结果进一步证明了神经科医生监督、护士病例管理的卒中风险降低计划的临床有效性。
P157
Patients who have suffered a previous stroke or TIA and those with carotid artery disease are at a heightened risk for a first or recurrent stroke. In this study, we investigated the prevalence of potentially modifiable CVD risk factors in 247 consecutive patients at a private practice neurology clinic who had previously suffered a stroke or TIA and/or had documented carotid artery disease. We also evaluated the clinical effectiveness of 12 weeks (n=125) and 1 year (n=36) of participation by these patients in a neurologist supervised, nurse case managed stroke risk reduction program. At baseline, potentially modifiable CVD risk factors included physical inactivity (68% of patients), elevated systolic BP (54% of patients), elevated LDL cholesterol (46% of patients), obesity (36% of patients), elevated diastolic BP (32% of patients), and cigarette smoking (15% of patients). On completion of 12 weeks and 1 year of program participation, clinically relevant improvements were observed for select CVD risk factors in patients with abnormal baseline values (Table). These data demonstrate that potentially modifiable CVD risk factors are often suboptimally controlled in patients at high risk for stroke. Our results further document the clinical effectiveness of a neurologist supervised, nurse case managed stroke risk reduction program.