Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland. atte.meretoja@fi mnet.fi
Ann Med. 2011 Jun;43 Suppl 1:S22-30. doi: 10.3109/07853890.2011.586361.
This article in this supplement issue on the Performance, Effectiveness, and Costs of Treatment episodes (PERFECT) project describes trends in Finnish stroke treatment and outcome.
The PERFECT Stroke study uses multiple national registry linkages at individual patient level to produce a national stroke database with comprehensive follow-up of all hospital-treated stroke patients in Finland.
There were 94,316 incident stroke patients treated in Finnish hospitals from 1999 to 2007. Lengths-of-stays decreased after ischemic stroke (IS), and increased after intracerebral (ICH) and subarachnoid (SAH) hemorrhage. Ten-year survival improved in IS (hazard ratio 0.75; 95% CI 0.71-0.79) and ICH patients (0.88; 0.79-0.97), increasing median survival by 2 and 1 life-years respectively. This has translated into more days spent home among IS patients, but not among ICH patients. Treatment by neurologists improved the survival of IS (odds ratio [OR] 1.77; 95% CI 1.70-1.84) and ICH patients (OR 1.55; 95% CI 1.40-1.69), and treatment by neurosurgeons of SAH patients (OR 2.66; 95% CI 2.25-3.16), the effects were further improved by care in specialized stroke centers.
The survival of Finnish IS and ICH patients has improved. Specialized acute care was associated with improved outcome.
本期增刊中的这篇文章介绍了芬兰卒中治疗和结局的变化趋势，该研究隶属于治疗效果、效能和费用（PERFECT）项目。
PERFECT 卒中研究通过患者个体层面的多个全国性注册数据库的链接，构建了一个全国性的卒中数据库，其中包括芬兰所有医院治疗的卒中患者的全面随访数据。
1999 年至 2007 年期间，芬兰医院共治疗了 94316 例新发卒中患者。缺血性卒中（IS）患者的住院时间缩短，而颅内出血（ICH）和蛛网膜下腔出血（SAH）患者的住院时间延长。IS（危险比 0.75；95%可信区间 0.71-0.79）和 ICH 患者（0.88；95%可信区间 0.79-0.97）的 10 年生存率提高，分别使中位生存时间延长 2 年和 1 年。这导致 IS 患者在家中度过的天数增加，但 ICH 患者无此变化。神经科医生治疗可提高 IS（优势比 1.77；95%可信区间 1.70-1.84）和 ICH 患者（OR 1.55；95% CI 1.40-1.69）的生存率，神经外科医生治疗 SAH 患者（OR 2.66；95% CI 2.25-3.16）也可提高生存率，在专门的卒中中心治疗可进一步改善预后。
芬兰 IS 和 ICH 患者的生存率提高。急性治疗的专业性与改善结局相关。
