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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Case Fatality Decline from 2009 to 2013 among Medicare Beneficiaries with Ischemic Stroke
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Case Fatality Decline from 2009 to 2013 among Medicare Beneficiaries with Ischemic Stroke

机译：缺血性卒中的医疗保险受益者2009年至2013年的情况下降

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Objectives: This study aimed to examine the temporal trend of 30-day and 1-year mortality among U.S. Medicare beneficiaries who were hospitalized for ischemic stroke, with special focus on the mortality among subgroup of patients in relation to acute reperfusion therapies including intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT). Methods: We evaluated Medicare fee-for-service beneficiaries age 65 years or older who were hospitalized for ischemic stroke between 2009 and 2013. Multivariable Cox proportional hazards models were generated to analyze the trend of adjusted mortality. Results: A total of 1,070,574 patients were included in the study. The 30-day mortality did not change among patients who were not treated with IVT or EVT. It decreased by 13% among patients treated with IVT but not EVT (HR =.87, 95% CI.82-.92), 25% among patients treated with EVT but not IVT (HR =.75, 95% CI.59-.95), and 37% among patients treated with both IVT and EVT (HR =.63, 95% CI.52-.77). One-year mortality decreased by 19% among patients who were not treated with IVT nor EVT (HR =.81, 95% CI.80-.83), 22% among those treated with IVT but not EVT (HR =.78, 95% CI.75-.81), 33% among those treated with EVT but not IVT (HR =.67, 95% CI.55-.81), and 38% among those treated with both IVT and EVT (HR =.62, 95% CI.53-.73). Conclusions: From 2009 to 2013, the 30-day stroke case fatality decreased only among the patients received reperfusion therapy. The 1-year mortality declined among all the stroke patients, with the greatest decline among those treated with both IVT and EVT.
机译：目的：本研究旨在研究因缺血性卒中住院的美国医疗保险受益人30天和1年死亡率的时间趋势，特别关注与急性再灌注治疗（包括静脉溶栓（IVT）和血管内血栓切除术（EVT））相关的亚组患者的死亡率。方法：我们评估了2009年至2013年间65岁或以上因缺血性中风住院的服务受益人的医疗保险费用。多变量Cox比例风险模型用于分析调整后死亡率的趋势。结果：共有1070574名患者被纳入研究。未接受IVT或EVT治疗的患者的30天死亡率没有变化。在接受IVT而非EVT治疗的患者中，其死亡率下降了13%（HR=0.87，95%可信区间82-.92），在接受EVT而非IVT治疗的患者中，其死亡率下降了25%（HR=0.75，95%可信区间59-.95），在同时接受IVT和EVT治疗的患者中，其死亡率下降了37%（HR=0.63，95%可信区间52-.77）。未接受IVT或EVT治疗的患者一年死亡率下降19%（HR=.81，95%可信区间80-.83），接受IVT但未接受EVT治疗的患者一年死亡率下降22%（HR=.78，95%可信区间75-.81），接受EVT但未接受IVT治疗的患者一年死亡率下降33%（HR=.67，95%可信区间55-.81），同时接受IVT和EVT治疗的患者一年死亡率下降38%（HR=.62，95%可信区间53-.73）。结论：从2009年到2013年，只有接受再灌注治疗的患者的30天中风病死率有所下降。所有卒中患者的1年死亡率均下降，其中IVT和EVT治疗组的死亡率下降幅度最大。

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