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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Time to Presentation Is Associated with Clinical Outcome in Hemispheric Stroke Patients Deemed Ineligible for Recanalization Therapy
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Time to Presentation Is Associated with Clinical Outcome in Hemispheric Stroke Patients Deemed Ineligible for Recanalization Therapy

机译：介绍时间与视为重新化治疗不合格的半球中风患者的临床结果相关

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Background: Delayed thrombolysis adversely impacts functional outcome after stroke. Therefore, great efforts are undertaken to reduce delay in patient presentation and initiate treatment as quickly as possible. However, little is known regarding the impact of time to presentation (TTP) on outcome in patients who are ineligible for acute stroke therapy. Thus, we sought to determine whether the TTP is associated with the 90-day outcome irrespective of eligibility for acute recanalization therapy. Methods: We retrospectively analyzed 258 consecutive acute ischemic stroke patients evaluated between January 2013 and February 2014. Multivariable logistic regression was used to determine whether a greater TTP is independently associated with a poor 90-day outcome defined as a modified Rankin scale (mRS) score of 3-6. Results: In the unadjusted analyses, the TTP was inversely correlated with transfer from an acute facility (r = -.126, P = .043), cardioembolic stroke etiology (r = -.146, P = .019), and acute recanalization therapy (r = .-412, P < .001). Conversely, a longer TTP was correlated with a worse 90-day mRS score (r = .127, P = .045). After adjustment, the TTP (P = .019), age (P < .001), female sex (P = .001), National Institutes of Health Stroke Scale score (P < .001), preadmission mRS score (P = .001), atrial fibrillation (P < .001), and infarct volume (P < .001) were independently associated with a poor 90-day outcome. Importantly, a longer TTP (odds ratio 1.016, 95% confidence interval 1.001-1.032, P = .036) remained independently associated with the 90-day outcome when we restricted the analyses to patients ineligible for acute intravenous and endovascular recanalization therapies. Conclusions: Each hour delay in the TTP decreased chances for good outcome by approximately 2% independent of patient eligibility for acute recanalization therapies. (C) 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
机译：背景：延迟溶栓对中风后功能性结果产生不利影响。因此，进行了巨大的努力，以减少患者介绍的延迟，并尽快启动治疗。然而，关于时间对急性卒中治疗的患者的结果的影响（TTP）的影响很少。因此，我们试图确定TTP是否与90天的结果相关联，而不管急性重慢治疗的资格。方法：我们回顾性分析了2013年1月和2014年2月之间的258例连续急性缺血性卒中患者。使用多变量的逻辑回归来确定更大的TTP是否与定义为改进的Rankin规模（MRS）得分的较差的90天结局是独立相关的3-6。结果：在不调整的分析中，TTP与来自急性设施的转移（R = -.126，P = .043），心脏栓塞行程病因（r = -146，p = .019）和急性重新化的转移相关治疗（r = -412，p <.001）。相反，较长的TTP与更糟糕的90天MRS得分相关（r = .127，p = .045）。调整后，TTP（p = .019），年龄（p <.001），女性（p = .001），国家健康卒中量表评分（p <.001），普罗德斯MRS得分（P =。 001），心房颤动（P <.001）和梗塞体积（P <.001）与较差的90天结果单独相关。重要的是，较长的TTP（差距1.016,95％置信区间1.001-1.032，P = .036）仍然与90天的结果无关，当我们限制对患者不符合急性静脉内和血管内重组疗法的患者时，与90天的结果无关。结论：TTP中的每一小时延迟良好的延迟减少了大约2％，与急性重新化治疗的患者资格无关。 （c）2016国家冲程协会。由elsevier Inc.保留所有权利发布。

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