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撒哈拉以南非洲公立医院的极简式卒中单元

Minimal Setting Stroke Unit in a Sub-Saharan African Public Hospital.

作者信息

Cisse Fode A, Damien Charlotte, Bah Aissatou K, Touré M L, Barry M, Djibo Hamani A B, Haba Michel, Soumah Fode M, Naeije Gilles

机构信息

Department of Neurology, CHU Ignace Deen, Université Gamal Abdel Nasser Conakry (UGANC), Conakry, Guinea.

Department of Neurology, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium.

出版信息

Front Neurol. 2019 Aug 7;10:856. doi: 10.3389/fneur.2019.00856. eCollection 2019.

Abstract

Sub-Saharan Africa (SSA) has the highest stroke prevalence along with a case fatality that amounts to 40%. We aimed to assess the effect of a minimal setting stroke unit in SSA Public hospital on stroke mortality and main medical complications. The study was set in Conakry, Guinea, Ignace Deen public referral hospital. Clinical characteristics, hospital mortality and main medical stroke complications rates (pneumonia, urinary tract infections, sores and venous thromboembolism) of admitted stroke patients after the installation of a minimal stroke unit equipped with heart rate, blood pressure and blood oxygen saturation monitoring and portable oxygen concentrator (POST) were compared to a similar number of stroke patients admitted before the stroke unit creation (PRE). PRE ( = 318) and POST ( = 361) stroke, patients were comparable in term of age (61 ± 14 vs. 60 ± 14.8 years, = 0.24), sex (56 vs. 50% males, = 0.09), High blood pressure rate (76.7 vs. 79%, = 0.44), stroke subtype (ischemic in 72 vs. 78% of cases, = 0.05) and NIHSS (11 ± 4 vs. 11 ± 4, = 0.85). Diabetes was more frequent in the PRE group (19 vs. 9%, p < 0.001). Mortality was significantly lower in the POST group (7.2 vs. 22.3%, < 0.0001) as well as medical complications (4.1 vs. 27.7%, < 0.001) and lower pneumonia rate (3.3 vs. 14.5%, < 0.001). Minimally equipped stroke units significantly reduce stroke mortality and main medical complications in SSA.

摘要

撒哈拉以南非洲地区(SSA)的中风患病率最高,病死率达40%。我们旨在评估SSA公立医院中一个简易卒中单元对中风死亡率和主要医疗并发症的影响。该研究在几内亚科纳克里的伊格纳西·迪恩公共转诊医院开展。将安装了配备心率、血压和血氧饱和度监测设备以及便携式制氧机(POST)的简易卒中单元后收治的中风患者的临床特征、医院死亡率和主要医疗中风并发症发生率(肺炎、尿路感染、褥疮和静脉血栓栓塞),与卒中单元设立前收治的数量相似的中风患者(PRE)进行比较。PRE组(n = 318)和POST组(n = 361)的中风患者在年龄(61±14岁 vs. 60±14.8岁,p = 0.24)、性别(男性分别为56%和50%,p = 0.09)、高血压发生率(76.7% vs. 79%,p = 0.44)、中风亚型(缺血性中风分别占72%和78%,p = 0.05)以及美国国立卫生研究院卒中量表(NIHSS)评分(11±4 vs. 11±4,p = 0.85)方面具有可比性。糖尿病在PRE组中更为常见(19% vs. 9%,p < 0.001)。POST组的死亡率显著更低(7.2% vs. 22.3%,p < 0.0001),医疗并发症发生率也更低(4.1% vs. 27.7%,p < 0.001),肺炎发生率也更低(3.3% vs. 14.5%,p < 0.001)。配备简易设备的卒中单元可显著降低SSA地区的中风死亡率和主要医疗并发症。

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