Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan.
Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
Br J Radiol. 2024 Jun 18;97(1159):1343-1350. doi: 10.1093/bjr/tqae082.
This study aims to evaluate such usage patterns and identify factors that may contribute to the need for repeat imaging in acute ischaemic stroke patients and determine the association between repeat imaging and readmission in Taiwan.
We searched and analysed data from the Taiwan National Health Insurance Research Database for patients admitted for acute ischaemic stroke between 2002 and 2017. Cases where repeat brain imaging during the initial hospital admission occurred and where patients were readmitted within 30 days following discharge were documented.
Of a total of 195 016 patients with new onset ischaemic stroke, 51 798 (26.6%) underwent repeat imaging during their initial admission. Factors associated with repeat brain imaging included younger age, longer hospital stay, use of recombinant tissue plasminogen activator (rt-PA) therapy (odds ratio = 2.10 [95% CI, 1.98-2.22]), more recent year of diagnosis, higher National Institutes of Health Stroke Scale (NIHSS) score, and admission to a hospital offering a higher level of care. Repeat imaging was also associated with an increased risk of ischaemic stroke and all types of stroke readmission.
Repeat brain imaging of patients with stroke has increased in recent years, and it is associated with certain factors including age, length of stay, use of rt-PA, hospital level of care, and NIHSS score. It is also associated with increased readmission.
Knowledge of the associations of repeat imaging may help clinicians use repeat imaging more carefully and efficaciously.
本研究旨在评估此类使用模式，并确定可能导致急性缺血性脑卒中患者需要重复影像学检查的因素，以及确定在台湾，重复影像学检查与再入院之间的关联。
我们从 2002 年至 2017 年台湾全民健康保险研究数据库中搜索并分析了因急性缺血性脑卒中入院的患者数据。记录了初次住院期间重复脑部成像的病例，以及出院后 30 天内再次入院的病例。
在总共 195016 例新发缺血性脑卒中患者中，51798 例（26.6%）在初次入院期间进行了重复影像学检查。与重复脑部成像相关的因素包括年龄较小、住院时间较长、使用重组组织型纤溶酶原激活剂（rt-PA）治疗（比值比=2.10 [95%置信区间，1.98-2.22]）、较近的诊断年份、更高的国立卫生研究院卒中量表（NIHSS）评分以及入住提供更高水平护理的医院。重复影像学检查也与缺血性脑卒中及所有类型的脑卒中再入院风险增加相关。
近年来，对脑卒中患者进行重复脑部成像的需求有所增加，与某些因素相关，包括年龄、住院时间、rt-PA 的使用、医院的护理水平和 NIHSS 评分。它也与增加的再入院率相关。
了解重复影像学检查的相关性可能有助于临床医生更谨慎有效地使用重复影像学检查。
