Warwick Tanya, Kali Maher, Carter William, Lucas Kristi, Masood Shahana, Dawli Rana, Broce Mike, Reyes Bernardo
University of California-San Francisco, Fresno, California, USA.
Am J Med Qual. 2008 Nov-Dec;23(6):457-64. doi: 10.1177/1062860608324545. Epub 2008 Nov 4.
Stroke patients appear to have lower morbidity and mortality rates and better outcomes when neurologists serve as the primary admitting physician. The effect of neurological consultations on coronary artery bypass graft (CABG) patients who have suffered a postoperative transient ischemic attack (TIA) has not yet been determined. The authors evaluated whether neurology consultations improved outcomes. A retrospective analysis was conducted of CABG patients from a high-volume tertiary care center. Primary end points included 30-day mortality, discharge disposition, length of stay, and 1-year incidence of stroke. Post-CABG TIA patients receiving a neurological consult (N = 127) were compared with propensity-matched controls. Thirty-day mortality was identical (3.1%), with nonsignificant difference in long-term incidence of stroke. There were no differences in home discharges or length of stay. Including a neurologist in the treating team for patients suffering TIAs after CABG appears not to reduce post-operative incidence of morbidity and mortality, reduce length of stay, or improve patient disposition at discharge.
当神经科医生作为主要收治医生时，中风患者似乎具有较低的发病率和死亡率，且预后更好。神经科会诊对冠状动脉搭桥术（CABG）后发生术后短暂性脑缺血发作（TIA）的患者的影响尚未确定。作者评估了神经科会诊是否能改善预后。对一家大型三级医疗中心的CABG患者进行了回顾性分析。主要终点包括30天死亡率、出院情况、住院时间和1年中风发生率。将接受神经科会诊的CABG术后TIA患者（N = 127）与倾向匹配的对照组进行比较。30天死亡率相同（3.1%），中风的长期发生率无显著差异。家庭出院情况或住院时间也没有差异。在CABG术后发生TIA的患者治疗团队中纳入神经科医生似乎并不能降低术后发病率和死亡率、缩短住院时间或改善患者出院时的情况。
