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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Clinical Outcomes of Patients with Acute Basilar Artery Occlusion in Brazil: An Observational Study
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Clinical Outcomes of Patients with Acute Basilar Artery Occlusion in Brazil: An Observational Study

机译：巴西急性基底动脉闭塞患者的临床结果：观察研究

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Background Intravenous thrombolysis (IVT) and endovascular therapy (EVT) were proven safe and effective for anterior circulation proximal occlusions. However, the most appropriate recanalization strategy in patients with acute basilar artery occlusion (BAO) is still controversial. This study aimed to assess outcomes of patients with BAO at an academic stroke center in Brazil. Methods This is a retrospective analysis of consecutive patients with BAO from a prospective stroke registry at Ribeir?o Preto Medical School. Primary outcomes were mortality and favorable outcome (modified Rankin score [mRS] ≤3) at 90 days. After univariate analyses, multivariate logistic regressions were used to identify independent predictors of primary outcomes. Results Between August 2004 and December 2015, 63 (65% male) patients with BAO and median National Institutes of Health Stroke Scale (NIHSS) score of 31 (interquartile range: 19-36) were identified. Twenty-nine (46%) patients received no acute recanalization therapy, 15 (24%) received IVT, and 19 (30%) received EVT (68% treated with stent retrievers). Twenty-four (83%) patients treated conservatively died, and only 2 (7%) achieved an mRS less than or equal to 3. Among patients treated with acute recanalization therapies, 15 (44%) died, and 9 (26.5%) had a favorable outcome. On multivariate analysis, baseline systolic blood pressure (odds ratio [OR]?=?.97; 95% confidence interval [CI]: .95-0.99; P ?=?.023), posterior circulation Alberta Stroke Program Early CT score (OR?=?.62; 95% CI: .41-0.94; P ?=?.026), and successful recanalization (OR?=?.18; 95% CI: .04-0.71; P ?=?.015) were independent predictors of lower mortality. Baseline NIHSS (OR?=?1.40; 95% CI: 1.08-1.82; P ?=?.012), prior use of statins (OR?=?.003; 95% CI: .001-0.28; P ?=?.012), and successful recanalization (OR?=?.05; 95% CI: .001-0.27; P ?=?.009) were independent predictors of favorable outcome. There was no significant difference between the IVT group and the EVT group on primary outcomes. Conclusions BAO is associated with high morbidity and mortality in Brazil. Access to acute recanalization therapies may decrease mortality in those patients. ]]>
机译：背景技术静脉内溶栓（IVT）和血管内疗法（EVT）被证明对前循环近端闭塞的安全有效。然而，急性基底动脉闭塞患者（BAO）患者中最合适的再生策略仍存在争议。本研究旨在评估巴西学术中风中心的BAO患者的结果。方法是，从Ribeir的潜在中风登记处取得连续患者的回顾性分析？o Preto Medical School。主要结果是死亡率和有利的结果（改进的Rankin评分[Mrs]≤3）在90天时。在单变量分析之后，多变量逻辑回归用于识别主要结果的独立预测因子。结果2004年8月至2015年12月期间，63名（65％的男性）患者BAO和中位国家卫生卒中量表（NIHSS）得分为31（四分位数范围：19-36）。 29例（46％）患者没有接受急性重新化治疗，15名（24％）接受IVT，19（30％）接受EVT（68％用支架检索处理68％）。保守治疗的二十四个（83％）患者，只有2（7％）达到小于或等于3的MRS。在用急性重载疗法治疗的患者中，15名（44％）死亡，9例（26.5％）有一个有利的结果。在多变量分析中，基线收缩压（差距[或]？=α.97; 95％置信区间[CI]：.95-0.99; P？=α.023），后循环艾伯塔省行程计划早期CT评分（或者？=？62; 95％ci：.41-0.94; p？=Δ.026）和成功的再生化（或？=α.18; 95％CI：.04-0.71; P？= ?. 015 ）是死亡率降低的独立预测因子。基线NIHSS（或？=？1.40; 95％CI：1.08-1.82; p？=β.012），用他汀类药物（或？=α.003; 95％CI：.001-0.28; P？=？ .012）和成功的重新化（或？= = 05; 95％CI：.001-0.27; P？= 009）是有利的结果的独立预测因素。 IVT集团与主要结果之间没有显着差异。结论宝泽与巴西的发病率高和死亡率有关。进入急性重新化疗法可能会降低这些患者的死亡率。 ]]>

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