意大利坎帕尼亚地区缺血性脑卒中再通治疗的趋势和最新技术。

Trends of recanalization therapies and state of art for ischemic stroke treatment in Campania region, Italy.

机构信息

Department of Neurosciences, Reproductive and Odontostomatology, University of Naples "Federico II", Via Pansini, 5, Naples, Italy.

Neurology Unit, P.O. "San Leonardo", Castellammare Di Stabia, Italy.

出版信息

Neurol Sci. 2022 Dec;43(12):6865-6870. doi: 10.1007/s10072-022-06321-3. Epub 2022 Sep 8.

BACKGROUND

According to the last Italian report by the Ministry of Health in 2018, the estimated number of acute ischemic strokes (AIS) in Campania is 10,000/year, with an expected number of 1390 intravenous thrombolysis (IVT) and 694 mechanical thrombectomies (MT). In 2017, only 1.5% of expected patients received IVT and 0.2% MT. This study analyzed the trend of IVT and MT in 2019-2020 and depicted the state of art of Stroke Care in Campania.

METHODS

From the regional health task force, we obtained the hospital discharge forms from all private and public hospitals in Campania; we selected patients with a principal diagnosis of AIS and measured the rate of patients admitted to neurology units and the rate of IVT, MT, and IVT + MT for both 2019 and 2020.

RESULTS

In 2019, we observed 4817 admissions for AIS; 2858/4817 (59.3%) patients were admitted to neurology units. Out of 4817 patients, 192 received IVT, 165 MT, and 131 IVT + MT (488 treated patients; 10.1%). In 2020, we observed 4129 admissions for AIS; 2502/4129 (62.7%) patients were admitted to neurology units. Out of 4129 patients, 198 received IVT, 250 MT, and 180 IVT + MT (628 treated patients; 15.2%). These results showed that despite a reduction of AIS admissions in 2020, the relative and absolute rate of recanalization treatments increased. However, the number of patients who were not admitted to neurology units nor received acute treatments remained dramatically high.

CONCLUSION

Despite the development of acute treatments, the Campania Stroke Network still needs significative efforts to improve.

背景

根据 2018 年意大利卫生部的最新报告，坎帕尼亚地区每年约有 10000 例急性缺血性脑卒中（AIS），预计将有 1390 例患者接受静脉溶栓（IVT）治疗，694 例患者接受机械取栓（MT）治疗。然而，2017 年仅有 1.5%的预期患者接受了 IVT 治疗，0.2%的患者接受了 MT 治疗。本研究分析了 2019-2020 年 IVT 和 MT 的趋势，并描绘了坎帕尼亚地区脑卒中治疗的现状。

方法

我们从区域卫生工作组获得了坎帕尼亚地区所有私立和公立医院的出院记录；我们选择了主要诊断为 AIS 的患者，并测量了 2019 年和 2020 年神经内科收治患者的比例，以及 IVT、MT 和 IVT+MT 的治疗比例。

结果

2019 年，我们观察到 4817 例 AIS 患者入院；其中 2858/4817（59.3%）患者被收治入神经内科。在 4817 例患者中，有 192 例接受了 IVT 治疗，165 例接受了 MT 治疗，131 例接受了 IVT+MT 治疗（488 例接受治疗的患者；10.1%）。2020 年，我们观察到 4129 例 AIS 患者入院；其中 2502/4129（62.7%）患者被收治入神经内科。在 4129 例患者中，有 198 例接受了 IVT 治疗，250 例接受了 MT 治疗，180 例接受了 IVT+MT 治疗（628 例接受治疗的患者；15.2%）。这些结果表明，尽管 2020 年 AIS 患者入院人数有所减少，但再通治疗的相对和绝对比例有所增加。然而，仍有大量患者未被收治入神经内科，也未接受急性治疗。