MMWR Morb Mortal Wkly Rep. 2008 May 9;57(18):481-5.
Although the number of deaths from stroke has declined substantially since the 1960s, in 2004, stroke remained the third leading cause of death in the United States, after heart disease and cancer. Approximately 54% of U.S. stroke deaths in 2004 occurred outside of a hospital. Intravenous administration of tissue plasminogen activator has clinical benefits for patients with acute ischemic stroke; however, treatment should begin within 3 hours of symptom onset for these benefits to be realized. For hemorrhagic stroke, immediate surgery (e.g., aneurysm repair) is crucial to prevent rebleeding that results in serious impairment or death in 40% to 60% of cases. A revised objective of Healthy People 2010 is to increase to 83% the proportion of persons who are aware of the warning symptoms of stroke and the need to telephone 9-1-1 immediately if someone appears to be having a stroke (objective no. 12-8). To assess public awareness of stroke warning symptoms and the importance of seeking emergency care, CDC analyzed data from an optional module of the 2005 Behavioral Risk Factor Surveillance System (BRFSS) survey that was used in 13 states and the District of Columbia (DC). The results indicated that the percentages of respondents who recognized all five correct symptoms, identified an incorrect symptom, and recognized the need to telephone 9-1-1 was low; the percentage who met all three measures was 16.4%. In addition, disparities were observed by race/ethnicity, sex, and education level. Public health agencies, clinicians, and educators should continue to stress the importance of learning to recognize stroke symptoms and the need to telephone 9-1-1 when someone appears to be having a stroke.
尽管自20世纪60年代以来,中风死亡人数已大幅下降,但在2004年,中风仍是美国第三大死因,仅次于心脏病和癌症。2004年,美国约54%的中风死亡发生在医院外。静脉注射组织纤溶酶原激活剂对急性缺血性中风患者有临床益处;然而,为实现这些益处,治疗应在症状出现后3小时内开始。对于出血性中风,立即进行手术(如动脉瘤修复)对于预防再出血至关重要,因为再出血会导致40%至60%的病例出现严重损伤或死亡。《健康人民2010》修订后的目标是,将知晓中风警示症状以及知晓如果有人似乎中风应立即拨打911的人群比例提高到83%(目标编号12 - 8)。为评估公众对中风警示症状的知晓情况以及寻求紧急护理的重要性,美国疾病控制与预防中心(CDC)分析了2005年行为危险因素监测系统(BRFSS)调查中一个可选模块的数据,该调查在13个州和哥伦比亚特区(DC)使用。结果表明,识别出所有五个正确症状、识别出一个错误症状以及认识到拨打911必要性的受访者比例较低;三项指标全部达标的比例为16.4%。此外,在种族/族裔、性别和教育水平方面存在差异。公共卫生机构、临床医生和教育工作者应继续强调学会识别中风症状的重要性,以及当有人似乎中风时拨打911的必要性。