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首页> 外文期刊>BMC Neurology >Management, prognosis and predictors of unfavourable outcomes in patients newly hospitalized for transient ischemic attack: a real-world investigation from Italy
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Management, prognosis and predictors of unfavourable outcomes in patients newly hospitalized for transient ischemic attack: a real-world investigation from Italy

机译：新近住院的短暂性脑缺血发作患者的不良预后的管理，预后和预测因素：来自意大利的一项真实调查

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Background Understanding the gap between evidence-based recommendations and real-world management is important to inform priority setting and health service planning. Methods The 7,776 residents in the Italian Lombardy Region who were newly hospitalized for transient ischemic attack (TIA) during 2008–2009 entered into the cohort and were followed until 2012. Exposure to medical care including selected drugs, diagnostic procedures and laboratory tests was recorded. A composite outcome was employed taking into account all-cause death and hospitalization for stroke and acute myocardial infarction. A multivariable proportional hazards model was fitted to estimate hazard ratio, and 95% confidence intervals (CI), for the exposure-outcome association. Results During the first year after discharge, 8.6, 49.7 and 48.5% of patients did not use any drugs, diagnostic procedures and laboratory tests respectively. Patients exposed to medical care had 59% reduced risk (95% CI, 50 to 66%) with respect to those who did not use any of these services. Conclusions Although the Italian National Health System supplies universal coverage for healthcare, several TIA patients receive suboptimal care. Systematic improvements are necessary in order to improve patient outcomes.
机译：背景知识了解基于证据的建议与实际管理之间的差距，对于确定优先重点和制定医疗服务计划非常重要。方法在意大利伦巴第大区的7776名居民中，他们在2008年至2009年期间因短暂性脑缺血发作（TIA）新入院，并一直随访至2012年。对他们的医疗护理进行了记录，包括选择的药物，诊断程序和实验室检查。考虑到卒中和急性心肌梗死的全因死亡和住院治疗，采用了综合结果。拟合了多变量比例风险模型以估计风险比和95％置信区间（CI），用于暴露-结果关联。结果出院后第一年，分别有8.6、49.7和48.5％的患者未使用任何药物，诊断程序和实验室检查。与未使用任何这些服务的患者相比，接受医疗护理的患者降低了59％的风险（95％CI，50％至66％）。结论尽管意大利国家卫生系统为医疗保健提供了全民医疗保险，但仍有一些TIA患者得到了次优护理。为了改善患者预后，必须进行系统的改善。

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