[1]高洁雅,王雪梅,沈 燕,等.院内急性缺血性脑卒中诊断误延影响因素分析[J].介入放射学杂志,2023,32(09):894-898.
 GAO Jieya,WANG Xuemei,SHEN Yan,et al.Analysis of factors affecting the diagnosis delay of in-hospital acute ischemic stroke[J].journal interventional radiology,2023,32(09):894-898.
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院内急性缺血性脑卒中诊断误延影响因素分析()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
32
期数:
2023年09
页码:
894-898
栏目:
临床研究
出版日期:
2023-09-27

文章信息/Info

Title:
Analysis of factors affecting the diagnosis delay of in-hospital acute ischemic stroke
作者:
高洁雅 王雪梅 沈 燕 施海彬 包建英
Author(s):
GAO Jieya WANG Xuemei SHEN Yan SHI Haibin BAO Jianying.
Department of Interventional Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210029, China
关键词:
【关键词】 院内脑卒中 诊断 延误 预测因子
文献标志码:
A
摘要:
【摘要】 目的 探讨院内新发急性缺血性脑卒中(AIS)诊断延误的影响因素。方法 回顾性分析2015年1月至2019年6月于南京医科大学第一附属医院因非脑卒中相关疾病住院,并在住院期间新发AIS患者的临床资料。根据发病至影像学检查时间是否超过60 min,分为延误组和非延误组。采用单因素和多因素logistic回归分析诊断延误的影响因素。 结果 共计134例患者纳入研究。其中延误组109例(81.3%),非延误组25例(18.7%),延误组患者与非延误组相比,伴发冠心病比例更高(37.6%比16.0%,P=0.039),美国纽约心脏病协会(NYHA)心功能分级Ⅲ/Ⅳ级比例更高(45.9%比20.0%,P=0.018),院内AIS更常见发作于术后3 d内(30.0%比8.0%,P=0.022),AIS高危科室比例更低(55.0%比88.0%,P=0.002),基线美国国立卫生研究院卒中量表(NIHSS)评分更低(4比15,P<0.01),牛津郡社区脑卒中项目(OCSP)分型中完全前循环梗死(TACI)、部分前循环梗死(PACI)亚型较少(26.6%比92.0%,P<0.01),呼叫脑卒中团队会诊比例较低(30.3%比76.0%,P=0.002),发病至开立头颅影像学检查医嘱时间更长(66 min比15 min,P<0.01),发病至完成头颅影像学检查时间更长(145 min比41 min,P<0.01)。单因素及多因素logistic回归分析显示,NYHA心功能分级Ⅲ/Ⅳ级、AIS发作于术后3 d内、非AIS高危科室、较低的基线NIHSS评分、OCSP分型TACI和PACI亚型、未呼叫脑卒中团队会诊为诊断延误的独立危险因素。结论 院内AIS诊断延误普遍存在,较差的心功能分级、AIS发作于术后3 d内、卒中症状较轻及未呼叫脑卒中团队会诊为诊断延误的影响因素。

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备注/Memo

备注/Memo:
(收稿日期:2022- 07- 10)
(本文编辑:谷 珂)
更新日期/Last Update: 2023-09-26