Brechtel Leanne, Poupore Nicolas, Monroe Margaret, Knisely Krista, Sanders Carolyn, Edrissi Camron, Rathfoot Chase, Nathaniel Thomas I
University of South Carolina, School of Medicine-Greenville, 607 Grove Rd, Greenville, SC, USA.
University of South Carolina, School of Medicine-Greenville, 607 Grove Rd, Greenville, SC, USA.
Adv Med Sci. 2021 Sep;66(2):254-261. doi: 10.1016/j.advms.2021.04.003. Epub 2021 May 1.
The relationship between the telestroke technology and clinical risk factors in a dysplipidemic ischemic stroke population and neurologic outcomes is not fully understood. This issue was investigated in this study.
We analyzed retrospective data collected from a regional stroke registry to identify demographic and clinical risk factors in patients with improving (NIHSS ≤ 7) or worsening (NIHSS > 7) neurologic outcome in dyslipidemic ischemic stroke population. We used logistic multivariate models to identify independent predictors of improving or worsening outcome based on dyslipidemia disease status in ischemic stroke patients.
In the adjusted analysis for dyslipidemic ischemic stroke population, cholesterol reducer use (odd ratio; [OR] = 0.393, 95% confidence interval [CI], 0.176-0.879, P = 0.023) and direct admission (OR = 0.435, 95% CI, 0.199-0.953, P = 0.037) were more likely to be associated with neurologic improvement and no clinical or demographic factors were associated with poor neurologic outcome in dyslipidemic ischemic stroke patients treated in the telestroke network. For the ischemic stroke population without dyslipidemia, increasing age (OR = 1.070, 95% CI, 1.031-1.109, P < 0.001), coronary artery disease (OR = 3.633, 95% CI, 1.307-10.099, P = 0.013), history of drug or alcohol abuse (OR = 6.548, 95% CI, 1.106-38.777, P = 0.038), and improvement in ambulatory outcome (OR = 2.880, 95% CI, 1.183-7.010, P = 0.020) were associated with worsening neurological functions, while being Caucasian (OR = 0.294, 95% CI, 0.098-0.882, P = 0.029) was associated with improving neurologic functions.
Demographic and clinical risk factors among the dysplipidemic ischemic stroke population in the telestroke network were not associated with worsening neurologic functions.
血脂异常缺血性卒中人群中远程卒中技术与临床危险因素及神经学预后之间的关系尚未完全明确。本研究对这一问题进行了调查。
我们分析了从地区卒中登记处收集的回顾性数据,以确定血脂异常缺血性卒中人群中神经学预后改善(美国国立卫生研究院卒中量表[NIHSS]≤7)或恶化(NIHSS>7)的患者的人口统计学和临床危险因素。我们使用逻辑多元模型,根据缺血性卒中患者的血脂异常疾病状态,确定预后改善或恶化的独立预测因素。
在对血脂异常缺血性卒中人群的校正分析中,使用胆固醇降低药物(比值比;[OR]=0.393,95%置信区间[CI],0.176 - 0.879,P=0.023)和直接入院(OR=0.435,95%CI,0.199 - 0.953,P=0.037)更有可能与神经学改善相关,并且在远程卒中网络中接受治疗的血脂异常缺血性卒中患者中,没有临床或人口统计学因素与不良神经学预后相关。对于无血脂异常的缺血性卒中人群,年龄增加(OR=1.070,95%CI,1.031 - 1.109,P<0.001)、冠状动脉疾病(OR=3.633,95%CI,1.307 - 10.099,P=0.013)、药物或酒精滥用史(OR=6.548,95%CI,1.106 - 38.777,P=0.038)以及步行预后改善(OR=2.880,95%CI,1.183 - 7.010,P=0.020)与神经功能恶化相关,而白种人(OR=0.294,95%CI,0.098 - 0.882,P=0.029)与神经功能改善相关。
远程卒中网络中血脂异常缺血性卒中人群的人口统计学和临床危险因素与神经功能恶化无关。