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急性缺血性脑卒中血管内治疗后的医学并发症及预后。

Medical complications and outcome after endovascular therapy for acute ischemic stroke.

机构信息

Research Group of Surgery, Anesthesiology and Intensive Care, Medical Research Center Oulu, Oulu, Finland.

Departments of Neurology, Oulu University Hospital, Oulu, Finland.

出版信息

Acta Neurol Scand. 2021 Dec;144(6):623-631. doi: 10.1111/ane.13501. Epub 2021 Jul 14.

Abstract

AIM

Endovascular therapy (EVT) in acute stroke is an effective but invasive treatment which is frequently followed by various complications. The aim of the present study was to examine the rate of medical complications and other adverse events following EVT.

METHODS

Retrospective single-center study of 380 consecutive stroke patients who received EVT between the years 2015-2019.

RESULTS

A total of 234 (61.6%) patients had at least one recorded medical complication. The most common complication was pneumonia in 154 (40.5%) patients, followed by acute cardiac insufficiency in 134 (35.3%), and myocardial infarction in 22 (5.8%) patients. In multivariate analysis, the need for general anesthesia (OR 3.8 (1.9-7.7)), Charlson Comorbidity Index >3 (OR 1.3 (1.1-1.5)), male gender (1.9 (1.1-1.3)) and high National Institutes of Health Stroke Scale (NIHSS) score at admission (1.1 (1.0-1.2)) were associated with medical complications.

CONCLUSION

Medical complications are common among unselected stroke patients undergoing EVT. Both comorbidity and stroke severity have an influence on medical complications. Early recognition of complications is essential, because vast majority of patients encountering medical complications have a poor short-term outcome.

摘要

目的

急性脑卒中的血管内治疗(EVT)是一种有效的侵入性治疗方法,但常伴有多种并发症。本研究旨在探讨 EVT 后医疗并发症和其他不良事件的发生率。

方法

回顾性分析 2015 年至 2019 年间接受 EVT 的 380 例连续脑卒中患者的单中心研究。

结果

共有 234 例(61.6%)患者至少记录了一次医疗并发症。最常见的并发症是肺炎,有 154 例(40.5%)患者,其次是急性心功能不全,有 134 例(35.3%)患者,心肌梗死有 22 例(5.8%)患者。多因素分析显示,需要全身麻醉(OR 3.8(1.9-7.7))、Charlson 合并症指数>3(OR 1.3(1.1-1.5))、男性(1.9(1.1-1.3))和入院时 NIHSS 评分较高(1.1(1.0-1.2))与医疗并发症相关。

结论

在接受 EVT 的未选择的脑卒中患者中,医疗并发症很常见。合并症和卒中严重程度对医疗并发症都有影响。早期识别并发症至关重要,因为绝大多数发生医疗并发症的患者短期预后不良。

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