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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >A National Evaluation of Door-to-Imaging Times among Acute Ischemic Stroke Patients within the Veterans Health Administration
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A National Evaluation of Door-to-Imaging Times among Acute Ischemic Stroke Patients within the Veterans Health Administration

机译：退伍军人卫生管理局对急性缺血性中风患者门成像时间的国家评估

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Background: Rapid brain imaging for ischemic stroke is important for patient outcomes. We sought to determine the proportion of ischemic stroke patients receiving brain imaging within the guideline-recommended 24 hours, and predictors of faster imaging among patients with acute symptoms. Methods: Retrospective analysis of Veterans Health Administration (VHA) Office of Performance Measurement Stroke Special Project data. Of 3000 ischemic stroke patients, secondary samples included 649 presenting within 6 hours of onset, and 217 potentially tissue plasminogen activator (tPA)-eligible patients (onset-to-arrival time,3 hours, National Institutes of Health Stroke Scale >2). Two linear regression models examined the association between door-to-imaging time and predictors among secondary samples, accounting for clustering within hospital. Results: Of the 3000 ischemic stroke patients, 97.1% had brain imaging within 24 hours. Among patients presenting within 6 hours of onset, median door-to-imaging time was 59 minutes (interquartile range [IQR], 33-109). Predictors of faster door-to-imaging time included elevated arrival blood pressure and stroke center presentation. Among the potentially tPA-eligible patients, median door-to-imaging time was 52 minutes (IQR, 31-105); no significant predictors were identified. Conclusions: Nearly all ischemic stroke patients at VHA hospitals have door-to-imaging time within 24 hours. There remains room for improvement for timely brain imaging among patients with acute symptom onset.
机译：背景：缺血性中风的快速脑成像对患者预后至关重要。我们试图确定在指南推荐的24小时内接受脑部影像学检查的缺血性卒中患者的比例，以及具有急性症状的患者中影像学检查速度加快的预测指标。方法：对退伍军人卫生管理局（VHA）绩效评估中风特别项目办公室的数据进行回顾性分析。在3000名缺血性中风患者中，次要样本包括在发病6小时内出现的649例患者和217例可能符合组织纤溶酶原激活剂（tPA）的患者（发病至到达时间3个小时，美国国立卫生研究院卒中量表> 2）。两种线性回归模型检查了门到成像时间与二次样本之间的预测变量之间的关联，从而说明了医院内的聚类情况。结果：在3000例缺血性中风患者中，97.1％的患者在24小时内进行了脑成像。在发病后6小时内出现的患者中，门到成像的中位时间为59分钟（四分位间距[IQR]，33-109）。门到成像时间更快的预测因素包括到站血压升高和中风中心表现。在可能符合tPA资格的患者中，门到成像的中位时间为52分钟（IQR，31-105）。没有发现重要的预测因素。结论：VHA医院中几乎所有缺血性中风患者的成像时间都在24小时之内。对于急性症状发作的患者，及时进行脑成像仍有改进的空间。

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