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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Practice Variation in Long-term Secondary Stroke Prevention in The Netherlands
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Practice Variation in Long-term Secondary Stroke Prevention in The Netherlands

机译：荷兰长期中风预防的实践差异

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Background: Stroke guidelines emphasize the importance of adequate vascular risk factor assessment and management in transient ischemic attack (TIA) and ischemic stroke patients, but it is not clear how these guidelines are applied in routine clinical practice. The limited data that are available indicate that TIA and ischemic stroke patients often do not receive the recommended interventions. The aim of this study was to investigate practice variations in long-term secondary stroke prevention in The Netherlands. Methods: Between June and December 2013, an invitation for a web-based survey was sent to 90 Dutch neurologists with a special interest in stroke neurology. This web-based survey contained questions regarding the organization of outpatient care for TIA and ischemic stroke patients after initial hospital assessment, pharmacologic treatment, and nonpharmacologic strategies for long-term secondary prevention. Results: In total, 84 (93%) neurologists completed the survey. Although nearly all respondents reported that they follow-up TIA and ischemic stroke patients after initial hospital assessment, the number of follow-up visits and the follow-up duration were variable. A similar variation was found in treatment targets levels for both blood pressure and low-density lipoprotein cholesterol. Regarding nonpharmacologic strategies for long-term secondary stroke prevention, most respondents inform their TIA and ischemic stroke patients about the importance of smoking cessation. There is considerably less attention for the other lifestyle risk factors. Conclusions: We found considerable practice variation in long-term secondary stroke prevention. These variations may have an impact on the risk for stroke recurrence and cardiovascular disease in general.
机译：背景：中风指南强调了在短暂性脑缺血发作（TIA）和缺血性中风患者中进行充分的血管危险因素评估和管理的重要性，但尚不清楚这些指南如何在常规临床实践中应用。现有的有限数据表明，TIA和缺血性中风患者通常不接受推荐的干预措施。这项研究的目的是调查荷兰长期中风预防的实践差异。方法：2013年6月至2013年12月，向90位对中风神经病学特别感兴趣的荷兰神经病学家发送了基于网络的调查邀请。这项基于网络的调查包含有关在初步医院评估，药物治疗和长期二级预防的非药物策略后，TIA和缺血性中风患者的门诊服务组织的问题。结果：总共84位（93％）神经科医生完成了调查。尽管几乎所有受访者均表示，他们在初次住院评估后对TIA和缺血性中风患者进行了随访，但随访次数和随访持续时间是可变的。在血压和低密度脂蛋白胆固醇的治疗目标水平上也发现了类似的变化。对于长期预防继发性中风的非药物策略，大多数受访者将其戒烟的重要性告知其TIA和缺血性中风患者。对其他生活方式风险因素的关注大大减少。结论：我们发现长期的继发性中风预防有很大的实践差异。这些变化通常可能对中风复发和心血管疾病的风险产生影响。

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