Department of Rehabilitation, Hirosaki Stroke and Rehabilitation Center, Hirosaki, Aomori, Japan.
Clinical Research Support Centre, Hirosaki University Hospital, Hirosaki, Aomori, Japan; Department of Medical Informatics, Hirosaki University Hospital, Hirosaki, Aomori, Japan.
J Stroke Cerebrovasc Dis. 2021 May;30(5):105705. doi: 10.1016/j.jstrokecerebrovasdis.2021.105705. Epub 2021 Mar 10.
To investigate the effects of hydration with or without Hydroxyethyl Starch (HES) 130/0.4 on neurological outcomes and medical costs during hospitalisation in patients with a single infarction (SI) in the posterior lenticulostriate artery (LSA) territory.
In this retrospective, single-centre, non-blinded cohort study, SI in the posterior LSA was defined as an ischaemic lesion with a high-signal intensity area ≥20 mm. All patients received basic stroke care within 48 h of symptom onset between April 2015 and January 2019. Patients were divided into the following two groups by clinician's preference: 1) those administered HES 130/0.4 and 2) those receiving other infusion fluid. The relationships between hospital costs and hydration therapy type were examined.
Eighteen (31%) of 58 patients received HES 130/0.4. The HES group had a significantly lower total cost than the control group (3.6 vs. 6.4 million yen, p=0.006). Moreover, the HES group had a significantly shorter hospital stay duration (79.5 vs. 141.0 days) and lower National Institutes of Health Stroke Scale score on day 7. Multivariate analysis found that HES 130/0.4 administration was an independent factor associated with high costs.
Hydration therapy with HES 130/0.4 significantly decreased the total costs and hospitalisation duration of patients with SI in the posterior LSA territory.
研究在后纹状体动脉(LSA)区域单个梗死(SI)患者中,水化治疗联合或不联合羟乙基淀粉(HES)130/0.4 对神经功能结局和住院期间医疗费用的影响。
本回顾性、单中心、非盲队列研究中,将后 LSA 的 SI 定义为具有≥20mm 高信号强度区域的缺血性病变。所有患者均在症状发作后 48 小时内接受基本的卒中治疗。根据临床医生的偏好,将患者分为以下两组:1)接受 HES 130/0.4 治疗的患者;2)接受其他输液的患者。研究考察了住院费用与水化治疗类型之间的关系。
58 例患者中有 18 例(31%)接受了 HES 130/0.4 治疗。HES 组的总费用明显低于对照组(3600 万日元比 6400 万日元,p=0.006)。此外,HES 组的住院时间明显更短(79.5 天比 141.0 天),第 7 天 NIHSS 评分更低。多变量分析发现,HES 130/0.4 的应用是与高费用相关的独立因素。
在后 LSA 区域 SI 患者中,HES 130/0.4 水化治疗可显著降低总费用和住院时间。