Imaging Clinical Effectiveness and Outcomes Research, Center for Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Manhasset, NY; Siemens Medical Solutions USA Inc., Malvern, PA.
Imaging Clinical Effectiveness and Outcomes Research, Center for Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Manhasset, NY.
Air Med J. 2021 Mar-Apr;40(2):102-107. doi: 10.1016/j.amj.2020.12.007. Epub 2021 Jan 16.
The optimal patient transportation destination of acute ischemic stroke (AIS) patients remains uncertain. The purpose of this study was to evaluate the predictive variables that determine stroke outcomes depending on the patient transportation destination.
We performed a retrospective study using an AIS database consisting of patients who underwent thrombectomy admitted to our institution from November 1, 2011, through October 1, 2018.
A total of 171 patients were included in the statistical analysis; 42.1% (72/171) of patients were in the mothership group (directly admitted) and 57.9% (99/171) in the drip-and-ship group (transferred). Multivariable logistic regression revealed the predictive factors for favorable outcomes were driving distance (expressed in miles) between the patient's home and a comprehensive stroke center (CSC) (odds ratio [OR] = 0.95; 95% confidence interval [CI], 0.90-0.99; P = .035), absence of diabetes mellitus (OR = 3.60; 95% CI, 1.20-10.82; P = .022), lower National Institutes of Health Stroke Scale score at admission (OR = 0.91; 95% CI, 0.85-0.97; P = .003), and shorter symptom onset to CSC arrival time (expressed in hours) (OR = 0.84; 95% CI, 0.72-0.99; P = .038).
Our study revealed that a shorter driving distance between the patient's home and CSC, absence of diabetes, lower National Institutes of Health Stroke Scale score, and shorter onset to hospital arrival time positively impacted the outcomes of endovascularly treated AIS patients.
急性缺血性脑卒中(AIS)患者的最佳转运目的地仍不确定。本研究旨在评估根据患者转运目的地确定脑卒中结局的预测变量。
我们使用 2011 年 11 月 1 日至 2018 年 10 月 1 日期间我院收治的接受取栓治疗的 AIS 患者数据库进行回顾性研究。
共有 171 例患者纳入统计分析;42.1%(72/171)的患者在母舰组(直接收治),57.9%(99/171)在滴注转运组。多变量逻辑回归显示,有利于转归的预测因素是患者住所与综合卒中中心(CSC)之间的驾驶距离(以英里为单位)(优势比[OR] = 0.95;95%置信区间[CI],0.90-0.99;P = .035)、无糖尿病(OR = 3.60;95% CI,1.20-10.82;P = .022)、入院时国立卫生研究院卒中量表(NIHSS)评分较低(OR = 0.91;95% CI,0.85-0.97;P = .003),以及症状发作到 CSC 到达时间较短(以小时为单位)(OR = 0.84;95% CI,0.72-0.99;P = .038)。
我们的研究表明,患者住所与 CSC 之间的驾驶距离较短、无糖尿病、NIHSS 评分较低、发病到入院时间较短,对接受血管内治疗的 AIS 患者的结局有积极影响。