Gupta A, Thomas P
Department of Medicine, University Hospital, Cardiff, UK.
Int J Clin Pract. 2002 Jun;56(5):338-41.
Identification and modification of risk factors can prevent strokes. Certain previously unidentified risk factors for stroke can become apparent following admission with acute stroke. The aim of the study was to investigate the prior capture, identification and management of modifiable risk factors for stroke in patients admitted to a hospital following acute stroke. One hundred consecutive stroke patients admitted to a UK hospital were prospectively assessed for modifiable risk factors. The extent of pre-admission risk factor management was also determined. Pre-admission risk factors identified and effectively managed were hypertension in non-diabetics (28%), hypertension in diabetics (7%), previous cerebrovascular event (100%), diabetes (29%), smoking (50% counselled), atrial fibrillation (81%), hypercholesterolaemia (100%), excess alcohol (22% counselled) and obesity (52% counselled). Twenty-five new modifiable risk factors were identified following incident stroke. In conclusion, a significant number of patients admitted with acute stroke have their risk factors poorly identified and controlled in the community. Despite the trial evidence available, an evidence-practice gap exists and many stroke prevention opportunities are being missed.
识别和改变风险因素可预防中风。某些先前未被识别的中风风险因素在急性中风入院后可能会显现出来。本研究的目的是调查急性中风后入院患者中可改变的中风风险因素的先前发现、识别和管理情况。对一家英国医院收治的100例连续中风患者进行前瞻性评估，以确定可改变的风险因素，并确定入院前风险因素的管理程度。已识别并有效管理的入院前风险因素包括非糖尿病患者的高血压（28%）、糖尿病患者的高血压（7%）、既往脑血管事件（100%）、糖尿病（29%）、吸烟（50%接受劝告）、心房颤动（81%）、高胆固醇血症（100%）、过量饮酒（22%接受劝告）和肥胖（52%接受劝告）。中风发病后发现了25个新的可改变风险因素。总之，大量急性中风入院患者的风险因素在社区中未得到充分识别和控制。尽管有现有试验证据，但存在证据与实践的差距，许多中风预防机会正在被错过。
