JAMA Neurol:短暂性脑缺血发作和轻微脑卒中患者护理质量评估

2018-02-06 zhangfan MedSci原创

研究发现,不同指南护理要素在短暂性脑缺血发作和轻微脑卒中患者治疗过程中依从性差异显著,充分的脑出血护理绩效评估对改善患者预后具有重要作用

对于短暂性脑缺血发作(TIA)和轻微脑卒中患者,及时接受指南护理可降低血管事件复发风险。近日研究人员考察了治疗护理指南在TIA和轻微脑卒中患者治疗过程中的应用情况。

研究人员对退伍军人医疗数据库进行考察,总计8201名TIA和轻微脑卒中患者参与。研究的主要终点是10大护理要素的实施情况。

研究参与者平均年龄68.8岁,男性占96.0%,白人占59.2%。护理要素实施情况如下:D2脑显像(6720/7563[88.9%]; 95% CI, 88.2%-89.6%)、D2抗血栓治疗(6265/7477 [83.8%]; 95% CI, 83.0%-84.6%)、出院或D120血红蛋白A1C检测(2859/3464 [82.5%]; 95% CI, 81.2%-83.8%)、出院D7房颤抗凝治疗(1003/1222 [82.1%]; 95% CI, 80.0%-84.2%)、D2深静脉血栓预防(3253/4346[74.9%]; 95%,CI,73.6%-76.2%)、出院D90血压控制 (4292/5979 [71.8%]; 95% CI, 70.7%-72.9%)、D1神经病学咨询 (5521/7823 [70.6%]; 95% CI, 69.6%-71.6%),D1-2心电图监测 (5073/7570 [67.0%]; 95% CI, 65.9%-68.1%),D2或6个月内颈动脉成像(4923/7685 [64.1%]; 95% CI, 63.0%-65.2%), 出院7天中高效价他汀类药物治疗(3329/7054 [47.2%]; 95% CI, 46.0%-48.4%)。

研究发现,不同指南护理要素在短暂性脑缺血发作和轻微脑卒中患者治疗过程中依从性差异显著,充分的脑出血护理绩效评估对改善患者预后具有重要作用。

原始出处:

Dawn M. Bravata et al. Quality of Care for Veterans With Transient Ischemic Attack and Minor Stroke. JAMA Neurol. February 5, 2018.

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    2018-11-12 yinhl1978
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