缺血性脑卒中死亡率与入院时间：90 天内分析。
Ischemic stroke mortality and time for hospital arrival: analysis of the first 90 days.
机构信息
Universidade Federal da Bahia, Escola de Enfermagem, Salvador, BA, Brazil.
Universidade Federal da Bahia, Instituto de Ciências da Saúde, Salvador, BA, Brazil.
出版信息
Rev Esc Enferm USP. 2023 Apr 14;57:e20220309. doi: 10.1590/1980-220X-REEUSP-2022-0309en. eCollection 2023.
OBJECTIVE
To analyze the association between time of arrival at a reference hospital and mortality of people with ischemic stroke.
METHOD
Descriptive and inferential statistics were used. Modifying and confounding variables between time of arrival and mortality were observed in the multivariate analysis. The Akaike Information Criterion was used to choose the model. Statistical significance of 5% and risk correction using the Poisson Model were adopted.
RESULTS
Most participants arrived within 4.5 hours of symptom onset or wake up stroke to the referral hospital and 19.4% died. The score of the National Institute of Health Stroke Scale was a modifier. In the multivariate model stratified by scale score ≥14, arrival time >4.5h was associated with lower mortality; and age ≥60 years and having Atrial Fibrillation, to higher mortality. In the model stratified by score ≤13, previous Rankin ≥3, and presence of atrial fibrillation were predictors of mortality.
CONCLUSION
The relationship between time of arrival and mortality up to 90 days was modified by the National Institute of Health Stroke Scale. Prior Rankin ≥3, atrial fibrillation, time to arrival ≤4.5h, and age ≥60 years contributed to higher mortality.
目的
分析到达参考医院的时间与缺血性脑卒中患者死亡率之间的关系。
方法
采用描述性和推断性统计方法。在多变量分析中观察到达时间和死亡率之间的调整和混杂变量。采用赤池信息量准则选择模型。采用 5%的统计学意义和泊松模型进行风险校正。
结果
大多数患者在症状发作或醒来中风后 4.5 小时内到达转诊医院，其中 19.4%死亡。国立卫生研究院卒中量表评分是一个调整因素。在按量表评分≥14 分层的多变量模型中，到达时间＞4.5h 与死亡率降低相关；年龄≥60 岁和心房颤动与死亡率升高相关。在按评分≤13 分层的模型中，既往 Rankin≥3 和心房颤动是死亡率的预测因素。
结论
国立卫生研究院卒中量表对到达时间与 90 天内死亡率之间的关系进行了调整。既往 Rankin≥3、心房颤动、到达时间≤4.5h 和年龄≥60 岁与死亡率升高相关。
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