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中国内地脑卒中患者院前延误的流行率及其决定因素:系统评价和研究方案的荟萃分析。

Prevalence and determinants of prehospital delay among stroke patients in mainland China: A systematic review and meta-analysis of the study protocol.

机构信息

North Sichuan Medical University, Nanchong, China.

Department of Neurology, Panzhihua Central Hospital, Panzhihua, China.

出版信息

PLoS One. 2024 Oct 24;19(10):e0312551. doi: 10.1371/journal.pone.0312551. eCollection 2024.

Abstract

BACKGROUND

Prehospital delay is one of the most serious problems in the treatment of stroke patients. In China, although hospitals at all levels have promoted the construction of stroke centers, pre-hospital delays are still very common. As the primary cause of death and disability, stroke not only brings great harm to patients themselves, but also brings a heavy burden on social progress and economic development, it is important to understand the prevalence and determinants of prehospital delay among stroke patients. Therefore, this review aims to determine the pooled prevalence and determinants of prehospital delay in mainland China.

METHODS

A systematic review of eligible articles will be conducted using preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. A comprehensive literature search will be conducted in PubMed, Embase, Cochrane, web of science, China National Knowledge Infrastructure (CNKI), Wanfang, Weipu (VIP) and Chinese Biomedicine Iiterature databas (CBM) databases. The quality of the articles included in the review will be evaluated using the Newcastle-Ottawa Scale (NOS). The pooled prevalence of prehospital delay, and odds ratio and their 95% confidence intervals for relevant influencing factors, will be calculated using RevMan 5.3 software. The existence of heterogeneity among studies will be assessed by computing p-values of Higgins's I2 test statistics and Cochran's Q-statistics. Sensitivity analysis and subgroup analysis will be conducted based on study quality to investigate the possible sources of heterogeneity. Publication bias will be evaluated by funnel chart and by Egger's regression test. This review protocol has been registered PROSPERO (CRD42023484580).

DISCUSSION

By collecting and summarizing information on prehospital delay among stroke patients can be a step towards a better understanding of the prevalence of prehospital delay among stroke patients in mainland China and how the associated factors influence the prevalence of prehospital delay. Therefore, a rapid, accurate diagnosis Stroke, timely pre-hospital first aid, the treatment process forward, for the patient It has great significance. This summarized finding at the national level will provide new clues for intervention to reduce the rate of pre-hospital delay of stroke patients, and is expected to further improve the treatment effect of stroke patients.

摘要

背景

院前延误是卒中患者治疗中最严重的问题之一。在中国,尽管各级医院都在推进卒中中心的建设,但院前延误仍然非常普遍。卒中作为首要的致死和致残原因,不仅给患者自身带来了极大的危害,也给社会进步和经济发展带来了沉重的负担,了解卒中患者院前延误的发生率和决定因素非常重要。因此,本综述旨在确定中国大陆卒中患者院前延误的汇总发生率和决定因素。

方法

将按照系统综述和荟萃分析的首选报告项目(PRISMA)指南对符合条件的文章进行系统综述。将在 PubMed、Embase、Cochrane、Web of Science、中国知网(CNKI)、万方、维普(VIP)和中国生物医学文献数据库(CBM)数据库中进行全面的文献检索。使用纽卡斯尔-渥太华量表(NOS)对纳入研究的质量进行评估。使用 RevMan 5.3 软件计算院前延误的汇总发生率、相关影响因素的比值比及其 95%置信区间。通过计算 Higgins 的 I 2 检验统计量和 Cochran 的 Q 检验的 p 值来评估研究之间的异质性。根据研究质量进行敏感性分析和亚组分析,以调查可能存在的异质性来源。通过漏斗图和 Egger 回归检验评估发表偏倚。本综述方案已在 PROSPERO 注册(CRD42023484580)。

讨论

通过收集和总结中国大陆卒中患者院前延误的信息,可以更好地了解中国大陆卒中患者院前延误的发生率以及相关因素如何影响院前延误的发生率。因此,快速、准确地诊断卒中,及时进行院前急救,治疗过程向前推进,对患者具有重要意义。在国家层面上总结这些发现将为减少卒中患者院前延误率的干预措施提供新的线索,并有望进一步提高卒中患者的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a74e/11500912/b81ce455452f/pone.0312551.g001.jpg

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