Lambert Clare McGarvey, Olulana Oluwaseyi, Bailey-Davis Lisa, Abedi Vida, Zand Ramin
Geisinger NeuroScience Institute, Geisinger Health System, Danville, PA 17822, USA.
Yale New Haven Hospital, Department of Neurology, New Haven, CT 06510, USA.
J Clin Med. 2021 Sep 17;10(18):4209. doi: 10.3390/jcm10184209.
Recurrent ischemic strokes are a cause of significant healthcare burdens globally. Patients with uncontrolled vascular risk factors are more likely to develop recurrent ischemic strokes. This study aims to compile information gained from current secondary prevention programs. A pre-defined literature search strategy was applied to PubMed, SCOPUS, CINAHL, and Google Scholar databases, and studies from 1997 to 2020 were evaluated for quality, study aims, and outcomes. The search produced 1175 articles (1092 after duplicates were removed) and titles were screened; 55 titles were retained for the full-text analysis. Of the remaining studies, 31 were retained for assessment, five demonstrated long-term effectiveness, eight demonstrated short-term effectiveness, and 18 demonstrated no effectiveness. The successful studies utilized a variety of different techniques in the categories of physical fitness, education, and adherence to care plans to reduce the risk of recurrent strokes. The lessons we learned from the current prevention programs included (1) offer tailored care for underserved groups, (2) control blood pressure, (3) provide opportunities for medication dosage titration, (4) establish the care plan prior to discharge, (5) invest in supervised exercise programs, (6) remove barriers to accessing care in low resource settings, and (7) improve the transition of care.
复发性缺血性中风是全球重大医疗负担的一个原因。血管危险因素未得到控制的患者更有可能发生复发性缺血性中风。本研究旨在汇总从当前二级预防项目中获得的信息。将预定义的文献检索策略应用于PubMed、SCOPUS、CINAHL和谷歌学术数据库，并对1997年至2020年的研究进行质量、研究目的和结果评估。检索产生了1175篇文章（去除重复后为1092篇）并对标题进行了筛选；保留55篇标题进行全文分析。在其余研究中，31篇被保留用于评估，5篇显示出长期有效性，8篇显示出短期有效性，18篇显示无效。成功的研究在体能、教育和护理计划依从性等类别中采用了各种不同的技术来降低复发性中风的风险。我们从当前预防项目中学到的经验教训包括：（1）为服务不足的群体提供量身定制的护理；（2）控制血压；（3）提供药物剂量滴定的机会；（4）在出院前制定护理计划；（5）投资于有监督的运动项目；（6）消除低资源环境中获得护理的障碍；（7）改善护理过渡。
