West China School of Nursing, Sichuan University, Chengdu, People's Republic of China.
Department of Neurology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
Contemp Nurse. 2022 Aug;58(4):264-275. doi: 10.1080/10376178.2022.2107038. Epub 2022 Sep 19.
To evaluate the relationship between nursing assessment findings at discharge and acute ischaemic stroke (AIS) patient prognosis after mechanical thrombectomy (MT).
We analysed the characteristics of 144 AIS patients with MT treatment admitted to a university affiliated teaching hospital in Chengdu, Sichuan Province China, from January 2020 to December 2020. The modified Rankin Scale (mRS) score was used to assess outcomes 90-days after discharge. Exploratory analyses were undertaken using IBM SPSS Statistics (Version 26.0).
At 90-days, 47.9% ( = 69) had a good prognosis (mRS ≤ 2) including 22.2% ( = 32) fully recovered patients. There were 5 (3.5%) deceased patients and 48.6% ( = 70) of patients had a poor prognosis (mRS ≥ 3). In univariate analysis, clinical prognosis correlated with the need for inpatient endotracheal intubation ( = 0.02), nasogastric tube (0.001), indwelling urinary catheter (0.001), central venous catheter (= 0.03), health knowledge needs of pressure injury prevention (= 0.03), National Institute of Health Stroke Scale (NIHSS) score (0.001) and Activities of Daily Living (ADL) score (0.001) at the time of discharge from hospital. The average hospitalization time of the 144 patients was 12[IQR, 9-25] days, and the average cost of hospitalization was $Y$21291.93 (SD 9165.01).
Almost half of the surviving patients had a poor prognosis. In our country, this surgery and rehabilitation impose a significant financial burden that needs to be addressed. However, the longer length of hospital stay and higher costs at discharge may be contributing factors to worse outcomes. The outcomes of comprehensive nursing assessment of the patients, including nursing needs, activities of daily living, and neurological function, can predict their outcome.
We recommend a comprehensive nursing assessment at discharge that predicts patient outcomes and can be used for subsequent targeted interventions. The prognosis of patients with acute ischaemic stroke after mechanical thrombectomy is poor, and the financial burden needs to be considered.
评估出院时护理评估结果与机械取栓（MT）后急性缺血性脑卒中（AIS）患者预后之间的关系。
我们分析了 2020 年 1 月至 2020 年 12 月期间在四川省成都市一家大学附属医院接受 MT 治疗的 144 例 AIS 患者的特征。出院后 90 天采用改良 Rankin 量表（mRS）评分评估结局。采用 IBM SPSS Statistics（版本 26.0）进行探索性分析。
90 天时，47.9%（ = 69）预后良好（mRS≤2），包括 22.2%（ = 32）完全恢复的患者。有 5 例（3.5%）死亡患者，48.6%（ = 70）的患者预后不良（mRS≥3）。单因素分析显示，临床预后与住院期间需要经口气管插管（ = 0.02）、鼻饲管（0.001）、留置导尿管（0.001）、中心静脉导管（ = 0.03）、压疮预防健康知识需求（ = 0.03）、国立卫生研究院卒中量表（NIHSS）评分（0.001）和日常生活活动（ADL）评分（0.001）有关。144 例患者的平均住院时间为 12[IQR，9-25]天，平均住院费用为$Y$21291.93（SD 9165.01）。
几乎一半的存活患者预后不良。在我国，这种手术和康复治疗带来了巨大的经济负担，需要加以解决。然而，更长的住院时间和出院时更高的费用可能是导致预后更差的因素。对患者进行全面的护理评估，包括护理需求、日常生活活动和神经功能，可预测其结局。
我们建议在出院时进行全面的护理评估，以预测患者的预后，并可用于随后的有针对性的干预。机械取栓后急性缺血性脑卒中患者的预后较差，需要考虑经济负担。
