Allina Health Neuroscience, Spine, and Pain Institute, Minneapolis, MN, USA.
Allina Health, Minneapolis, MN, USA.
J Stroke Cerebrovasc Dis. 2023 Aug;32(8):107189. doi: 10.1016/j.jstrokecerebrovasdis.2023.107189. Epub 2023 Jun 20.
To validate a comorbidity index specific to neurovascular patients and determine its performance relative to the Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Index (ECI) among ischemic stroke patients receiving reperfusion treatments.
Patients with ischemic stroke were identified in the National Inpatient Sample from Quarter 4 2015 to Quarter 4 2017. Ischemic stroke patients receiving reperfusion treatment, either with intravenous thrombolysis (IVT) only or mechanical thrombectomy (MT), were studied. The accuracy of the neurovascular comorbidities index (NCI) was compared to both the CCI and ECI in predicting in-hospital death and poor outcome (defined as death prior to discharge or discharge to a short-term hospital, a skilled nursing facility, an intermediate care facility, another long-term facility, or home health care).
There were 25,147 ischemic stroke patients who received reperfusion therapy with either IVT only or MT (with or without IVT). Approximately 6.9% of patients died during their hospitalization, and 65.4% of patients were classified as having a poor outcome based on their discharge disposition. The NCI outperformed both the CCI and ECI in predicting in-hospital death (IVT only, p<0.0001; MT, p<0.0001) and poor outcomes (IVT only, p<0.0001; MT, p<0.0001).
The NCI is a more powerful predictor of in-hospital death and poor outcomes when compared to the CCI or ECI among ischemic stroke patients receiving reperfusion therapies. Further validation studies are needed to confirm the accuracy of the NCI among other neurovascular patient populations.
验证一种专门针对神经血管患者的合并症指数，并确定其在接受再灌注治疗的缺血性脑卒中患者中相对于 Charlson 合并症指数（CCI）和 Elixhauser 合并症指数（ECI）的表现。
在 2015 年第 4 季度至 2017 年第 4 季度的国家住院患者样本中确定缺血性脑卒中患者。研究接受再灌注治疗（仅静脉溶栓（IVT）或机械血栓切除术（MT））的缺血性脑卒中患者。比较神经血管合并症指数（NCI）与 CCI 和 ECI 在预测住院内死亡和不良结局（定义为出院前死亡或出院至短期医院、熟练护理设施、中级护理设施、其他长期设施或家庭保健）方面的准确性。
共有 25147 例接受 IVT 或 MT（单独或联合 IVT）再灌注治疗的缺血性脑卒中患者。约有 6.9%的患者在住院期间死亡，65.4%的患者根据出院处置情况被归类为不良结局。NCI 在预测住院内死亡（仅 IVT，p<0.0001；MT，p<0.0001）和不良结局（仅 IVT，p<0.0001；MT，p<0.0001）方面优于 CCI 和 ECI。
与接受再灌注治疗的缺血性脑卒中患者的 CCI 或 ECI 相比，NCI 是住院内死亡和不良结局的更有力预测指标。需要进一步的验证研究来确认 NCI 在其他神经血管患者群体中的准确性。
