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首页> 外文期刊>Journal of neurology >In-hospital ischaemic stroke treated with intravenous thrombolysis or mechanical thrombectomy
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In-hospital ischaemic stroke treated with intravenous thrombolysis or mechanical thrombectomy

机译：用静脉溶栓或机械血栓切除术治疗的医院缺血性脑卒中

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Patients with in-hospital strokes (IHS) may be eligible for recanalization therapies. The objective of this study is to compare outcomes in patients with IHS and community-onset strokes (COS) treated by recanalization therapy. We analysed data prospectively collected in consecutive patients treated by thrombolysis, thrombectomy, or both for cerebral ischemia at the Lille University Hospital. We compared four outcomes measures at 3 months in patients with IHS and COS: (1) modified Rankin scale (mRS) 0-1, (2) mRS 0-2, (3) death, and (4) symptomatic intracranial haemorrhage (ECASS 2 definition). Of 1209 patients, 64 (5.3%) had IHS, with an increasing proportion over time (p = 0.001). Their median onset-to-needle time was 128 min vs. 145 in COS (p < 0.001). They were more likely to have had a recent TIA [odds ratio (OR) 30.1; 95% confidence interval (CI) 11.5-78.7], to have been treated by vitamin K antagonist before (OR 4.2; 95% CI 1.4-12.0) and to undergo mechanical thrombectomy (45 vs. 10%, p < 0.001). They were less likely to have a pre-stroke mRS 0-1 (OR 0.22; 95% CI 0.09-0.50). After adjustment, IHS was not associated with any of the four outcome measures. Patients with IHS are treated 17 min earlier than patients with COS, but, taking into account that they were already in the hospital, delays are still too long. Their outcome does not differ from that of patients with COS, suggesting room for improvement if delays can be reduced. IHS being frequent, pre-specified pathways should be organised.
机译：患有医院中风（IHS）的患者可能有资格进行重新调整治疗。本研究的目的是将患有IHS患者的结果进行比较，并通过重组治疗治疗的社区发作卒中（COS）。我们分析了通过溶栓治疗，血栓切除术或脑缺血在里尔大学医院治疗的连续患者预期收集的数据。我们将四个结果与IHS和COS：（1）改进的Rankin规模（MRS）0-1，（2）MRS 0-2，（3）死亡和（4）症状颅内出血（ECASS 2定义）。 1209例患者中，64（5.3％）有IHS，随着时间的增加，比例增加（P = 0.001）。它们的中位数到针刺时间为128分钟，在COS中为145（P <0.001）。它们更有可能有最近的TIA [赔率比（或）30.1; 95％置信区间（CI）11.5-78.7]，以维生素K拮抗剂（或4.2; 95％CI 1.4-12.0）治疗，并进行机械血液切除术（45 vs.10％，P <0.001）。它们不太可能具有预卒中的MRS 0-1（或0.22; 95％CI 0.09-0.50）。调整后，IHS与四项结果措施中的任何一个无关。 IHS患者比COS的患者预先治疗17分钟，但考虑到他们已经在医院，延误仍然太长了。如果可以减少延迟，他们的结果与COS的患者的结果没有不同的患者。频繁，应组织预先指定的途径。

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