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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Early Recovery and Functional Outcome are Related with Causal Stroke Subtype: Data from the Tinzaparin in Acute Ischemic Stroke Trial
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Early Recovery and Functional Outcome are Related with Causal Stroke Subtype: Data from the Tinzaparin in Acute Ischemic Stroke Trial

机译：早期恢复和功能预后与卒中原因亚型有关：Tinzaparin在急性缺血性卒中试验中的数据

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Introduction: Baseline severity and causal subtype are predictors of outcome in ischemic stroke. We used data from the Tinzaparin in Acute Ischemic Stroke Trial (TAIST) to further assess the relationship among stroke subtype, early recovery, and outcome. Methods: Patients with ischemic stroke (<48 hours ictus) and enrolled into TAIST were included. Severity was measured prospectively as the Scandinavian Neurological Stroke Scale (SNSS) at days 0, 4, 7, and 10. Causal subtype as large artery atherosclerosis (LAA), cardioembolism (CE), or small vessel occlusion (SVO) was assigned after standard investigations. The rate of recovery was calculated as the change in SNSS at each time point. Functional outcome was assessed using the modified Rankin Scale (mRS) and Barthel Index at day 90. Results: Analyses were performed on the 1190 patients in TAIST who met criteria for LAA, CE, and SVO. The largest change in SNSS score occurred between baseline and day 4 and was greatest in SVO (median improvement 4 U), compared with LAA (median improvement 2 U) and CE (median improvement 2 U) (P < .0001). If no improvement in SNSS had occurred by day 4, irrespective of subgroup, then early recovery (median SNSS improvement by day 10: 2) and functional outcome (mRS 4) tended to be limited; patients who recovered early tended to continue to improve (median SNSS improvement by day 10: 11) and had a better outcome at day 90 (median, mRS 2). Conclusions: Recovery is related to causal subtype. In all subtypes most recovery occurred by day 4, and was predictive of longer-term functional outcome.
机译：简介：基线严重程度和因果亚型是缺血性卒中预后的指标。我们在急性缺血性卒中试验（TAIST）中使用了Tinzaparin的数据来进一步评估卒中亚型，早期康复和预后之间的关系。方法：纳入缺血性中风（<48小时发作）并入院的患者。在第0、4、7和10天时使用斯堪的纳维亚神经系统卒中量表（SNSS）进行前瞻性测量，并在标准后指定因果亚型，如大动脉粥样硬化（LAA），心脏栓塞（CE）或小血管闭塞（SVO）调查。恢复率计算为每个时间点SNSS的变化。在第90天，使用改良的Rankin量表（mRS）和Barthel指数评估功能结局。结果：对符合LAA，CE和SVO标准的1190例TAIST患者进行了分析。 SNSS分数的最大变化发生在基线和第4天之间，SVO（中位数改善4 U）最大，而LAA（中位数改善2 U）和CE（中位数改善2 U）最高（P <.0001）。如果到第4天，无论亚组如何，SNSS均没有改善，则早期恢复（第10天，SNSS改善中位数）和功能结局（mRS 4）趋于受限;早期恢复的患者倾向于继续改善（到第10天到第11天SNSS改善中值），并在第90天得到更好的结果（中值mRS 2）。结论：康复与因果亚型有关。在所有亚型中，大多数恢复在第4天发生，并预示了较长期的功能预后。

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