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首页> 外文期刊>Journal of Vascular and Interventional Neurology >The prognostic impact of the stroke unit care versus conventional care in treatment of patients with transient ischemic attack: a prospective population-based German study
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The prognostic impact of the stroke unit care versus conventional care in treatment of patients with transient ischemic attack: a prospective population-based German study

机译：脑卒中单元治疗与常规治疗对短暂性脑缺血发作患者的预后影响：一项基于人群的前瞻性德国研究

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Background and purpose: The risk of a stroke after a transient ischemic attack (TIA) is high in the short time following a TIA. The German Stroke Society recommends an early hospitalization of patients with TIA preferably in a stroke unit (SU). This study aims to compare the impact of SU care with conventional care (CC) in patients with TIA. Methods: In a prospective study, during a 36-month phase (starting November 2007), patients with TIA who were admitted to the hospital within 48 h of symptom onset were enrolled. Stroke rate during hospitalization and the 90-day rates of stroke and mortality were studied. Logistic regression analyses were used to estimate the odds ratio (OR). Results: Of 2,200 patients (mean age, 17.6 ± 12 years, 49% female), 1,347 (61%) treated in a SU and 853 (39%) received CC at general departments. Patients treated in SU were significantly younger than those received a CC (69.9 vs. 71.7 years; P = 0.001). TIA patients treated on SU received more ultrasound investigations of the neck arteries (98 vs. 96%; P = 0.003) and of the brain arteries (97 vs. 82%; P < 0.001) than those of CC. The primary outcomes (stroke during hospitalization, stroke after 90 days, and mortality after 90 days) did not show a difference between the SU and CC groups. In patients of male sex, the 90-day stroke rate was significantly lower in the SU group than the CC group (1.8 vs. 4.5%; P = 0.033). Using the adjusted logistic regression analysis, treatment in a SU revealed a reduction of 90-day stroke rate in patients of male sex (OR 0.38; 95% CI 0.15–0.95; P = 0.04). Conclusion: The impact of evaluation and treatment of patients with TIA in SU and CC appears to differ only among patients of male sex. Further randomized trials are necessary. Keywords: TIA, prognosis, stroke, stroke unit, mortality, management, hospitalization
机译：背景与目的：短暂性脑缺血发作（TIA）后中风的风险在TIA之后的短时间内很高。德国中风学会建议对TIA患者进行早期住院治疗，最好采用中风病房（SU）。这项研究旨在比较SU护理与传统护理（CC）对TIA患者的影响。方法：在一项为期36个月（从2007年11月开始）的前期研究中，纳入了在症状发作48小时内入院的TIA患者。研究了住院期间的中风发生率以及90天的中风发生率和死亡率。使用逻辑回归分析来估计比值比（OR）。结果：在2200名患者中（平均年龄17.6±12岁，女性49％），在SU部门接受治疗的患者有1347名（61％），在普通科接受了CC的有853名（39％）。 SU接受治疗的患者比接受CC的患者明显年轻（69.9比71.7岁; P = 0.001）。接受SU治疗的TIA患者比CC接受更多的颈动脉超声检查（98比96％; P = 0.003）和脑动脉超声检查（97比82％; P <0.001）。主要结局（住院期间的中风，90天后的中风和90天后的死亡率）在SU组和CC组之间没有差异。在男性患者中，SU组的90天卒中发生率显着低于CC组（1.8 vs. 4.5％; P = 0.033）。使用调整后的逻辑回归分析，SU的治疗显示男性患者的90天卒中率降低（OR 0.38; 95％CI 0.15-0.95; P = 0.04）。结论：TIA患者在SU和CC中评估和治疗的影响似乎仅在男性患者中有所不同。有必要进行进一步的随机试验。关键词：TIA，预后，中风，中风单位，死亡率，管理，住院

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