Stroke:卒中前行动不便患者血管内治疗的结局

2021-09-14 MedSci原创 MedSci原创

尽管PSMI患者的手术不良结局发生率并没有升高,但需要进一步研究以确定该人群的临床获益。

卒中前行动不便(PSMI)患者被排除在血管内临床试验之外。关于这类人群血管内血栓切除术的安全性和结局的数据十分有限。

近日,心血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员使用了一个大型的国家数据集来评估PSMI患者血管内血栓切除术的安全性和结局。

 
研究人员纳入了2015年至2019年期间接受血管内血栓切除术的患者。PSMI被定义为无法独立行走。研究人员采用Logistic回归模型的广义估计方程评估PSMI与结局之间的关联。

在接受血管内血栓切除术治疗的56762名患者中,2919名(5.14%)为PSMI患者。PSMI与有症状的颅内出血无关(6.0% vs. 5.4%;P=0.979)。32.3%的PSMI患者发生院内死亡或出院到临终关怀医院,而非PSMI患者为17.5%(调整后的比值比为1.45[1.32–1.58])。
 
由此可见,尽管PSMI患者的手术不良结局发生率并没有升高,但需要进一步研究以确定该人群的临床获益。

原始出处:

Rachel Beekman.et al.Outcomes of Endovascular Therapy in Patients With Prestroke Mobility Impairment.stroke.2021.https://www.ahajournals.org/doi/10.1161/STROKEAHA.121.034464

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1057403, encodeId=9761105e403a6, content=<a href='/topic/show?id=b64035999ca' target=_blank style='color:#2F92EE;'>#卒中#</a>尽管PSMI患者的手术不良结局发生率并没有升高,但需要进一步研究以确定该人群的临床获益。, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35999, encryptionId=b64035999ca, topicName=卒中)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTInOuicIVN8Y32NO4Q53Zpd86ObmNp2WIotichCD0qQHaUBeHj7hgwQBCzX7ce4aEw5ZP8icQQfLH9Zw/132, createdBy=4ec21734756, createdName=1def6e10m76(暂无匿称), createdTime=Mon Oct 04 09:06:54 CST 2021, time=2021-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1051435, encodeId=d5741051435e9, content=非常有意思的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c9771664520, createdName=tony要要要, createdTime=Wed Sep 15 10:40:35 CST 2021, time=2021-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1051326, encodeId=9009105132693, content=关注失能人群的人生终末治疗, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=df324723890, createdName=452946589, createdTime=Tue Sep 14 23:37:51 CST 2021, time=2021-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052604, encodeId=ac6d105260455, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Sep 14 22:44:28 CST 2021, time=2021-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1051302, encodeId=421c105130225, content=谢谢了, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cfdb5535422, createdName=ms5000001978187696, createdTime=Tue Sep 14 22:40:46 CST 2021, time=2021-09-14, status=1, ipAttribution=)]
    2021-10-04 1def6e10m76(暂无匿称)

    #卒中#尽管PSMI患者的手术不良结局发生率并没有升高,但需要进一步研究以确定该人群的临床获益。

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1057403, encodeId=9761105e403a6, content=<a href='/topic/show?id=b64035999ca' target=_blank style='color:#2F92EE;'>#卒中#</a>尽管PSMI患者的手术不良结局发生率并没有升高,但需要进一步研究以确定该人群的临床获益。, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35999, encryptionId=b64035999ca, topicName=卒中)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTInOuicIVN8Y32NO4Q53Zpd86ObmNp2WIotichCD0qQHaUBeHj7hgwQBCzX7ce4aEw5ZP8icQQfLH9Zw/132, createdBy=4ec21734756, createdName=1def6e10m76(暂无匿称), createdTime=Mon Oct 04 09:06:54 CST 2021, time=2021-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1051435, encodeId=d5741051435e9, content=非常有意思的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c9771664520, createdName=tony要要要, createdTime=Wed Sep 15 10:40:35 CST 2021, time=2021-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1051326, encodeId=9009105132693, content=关注失能人群的人生终末治疗, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=df324723890, createdName=452946589, createdTime=Tue Sep 14 23:37:51 CST 2021, time=2021-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052604, encodeId=ac6d105260455, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Sep 14 22:44:28 CST 2021, time=2021-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1051302, encodeId=421c105130225, content=谢谢了, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cfdb5535422, createdName=ms5000001978187696, createdTime=Tue Sep 14 22:40:46 CST 2021, time=2021-09-14, status=1, ipAttribution=)]
    2021-09-15 tony要要要

    非常有意思的研究

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1057403, encodeId=9761105e403a6, content=<a href='/topic/show?id=b64035999ca' target=_blank style='color:#2F92EE;'>#卒中#</a>尽管PSMI患者的手术不良结局发生率并没有升高,但需要进一步研究以确定该人群的临床获益。, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35999, encryptionId=b64035999ca, topicName=卒中)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTInOuicIVN8Y32NO4Q53Zpd86ObmNp2WIotichCD0qQHaUBeHj7hgwQBCzX7ce4aEw5ZP8icQQfLH9Zw/132, createdBy=4ec21734756, createdName=1def6e10m76(暂无匿称), createdTime=Mon Oct 04 09:06:54 CST 2021, time=2021-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1051435, encodeId=d5741051435e9, content=非常有意思的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c9771664520, createdName=tony要要要, createdTime=Wed Sep 15 10:40:35 CST 2021, time=2021-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1051326, encodeId=9009105132693, content=关注失能人群的人生终末治疗, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=df324723890, createdName=452946589, createdTime=Tue Sep 14 23:37:51 CST 2021, time=2021-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052604, encodeId=ac6d105260455, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Sep 14 22:44:28 CST 2021, time=2021-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1051302, encodeId=421c105130225, content=谢谢了, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cfdb5535422, createdName=ms5000001978187696, createdTime=Tue Sep 14 22:40:46 CST 2021, time=2021-09-14, status=1, ipAttribution=)]
    2021-09-14 452946589

    关注失能人群的人生终末治疗

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1057403, encodeId=9761105e403a6, content=<a href='/topic/show?id=b64035999ca' target=_blank style='color:#2F92EE;'>#卒中#</a>尽管PSMI患者的手术不良结局发生率并没有升高,但需要进一步研究以确定该人群的临床获益。, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35999, encryptionId=b64035999ca, topicName=卒中)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTInOuicIVN8Y32NO4Q53Zpd86ObmNp2WIotichCD0qQHaUBeHj7hgwQBCzX7ce4aEw5ZP8icQQfLH9Zw/132, createdBy=4ec21734756, createdName=1def6e10m76(暂无匿称), createdTime=Mon Oct 04 09:06:54 CST 2021, time=2021-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1051435, encodeId=d5741051435e9, content=非常有意思的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c9771664520, createdName=tony要要要, createdTime=Wed Sep 15 10:40:35 CST 2021, time=2021-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1051326, encodeId=9009105132693, content=关注失能人群的人生终末治疗, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=df324723890, createdName=452946589, createdTime=Tue Sep 14 23:37:51 CST 2021, time=2021-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052604, encodeId=ac6d105260455, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Sep 14 22:44:28 CST 2021, time=2021-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1051302, encodeId=421c105130225, content=谢谢了, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cfdb5535422, createdName=ms5000001978187696, createdTime=Tue Sep 14 22:40:46 CST 2021, time=2021-09-14, status=1, ipAttribution=)]
    2021-09-14 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1057403, encodeId=9761105e403a6, content=<a href='/topic/show?id=b64035999ca' target=_blank style='color:#2F92EE;'>#卒中#</a>尽管PSMI患者的手术不良结局发生率并没有升高,但需要进一步研究以确定该人群的临床获益。, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35999, encryptionId=b64035999ca, topicName=卒中)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTInOuicIVN8Y32NO4Q53Zpd86ObmNp2WIotichCD0qQHaUBeHj7hgwQBCzX7ce4aEw5ZP8icQQfLH9Zw/132, createdBy=4ec21734756, createdName=1def6e10m76(暂无匿称), createdTime=Mon Oct 04 09:06:54 CST 2021, time=2021-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1051435, encodeId=d5741051435e9, content=非常有意思的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c9771664520, createdName=tony要要要, createdTime=Wed Sep 15 10:40:35 CST 2021, time=2021-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1051326, encodeId=9009105132693, content=关注失能人群的人生终末治疗, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=df324723890, createdName=452946589, createdTime=Tue Sep 14 23:37:51 CST 2021, time=2021-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052604, encodeId=ac6d105260455, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Sep 14 22:44:28 CST 2021, time=2021-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1051302, encodeId=421c105130225, content=谢谢了, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cfdb5535422, createdName=ms5000001978187696, createdTime=Tue Sep 14 22:40:46 CST 2021, time=2021-09-14, status=1, ipAttribution=)]
    2021-09-14 ms5000001978187696

    谢谢了

    0

相关资讯

JAHA:卒中前残疾的急性缺血性脑卒中患者血管内治疗疗效分析

接受EVT的患者比接受内科治疗的患者可获得更好的功能结局。因此,仅以卒中前残疾为由拒绝EVT可能会失去获得良好结局的最佳机会。

JNNP:基底动脉闭塞的桥接与直接血管内治疗

急性缺血性脑卒中的血管内治疗因颅内大血管闭塞引起的前部缺血性脑卒中而广为接受。 80%以上的主要血管内临床试验患者在血管内治疗前接受了重组组织型纤溶酶原激活剂(rt-PA)静脉治疗,支持血管内治疗前应

JAMA子刊:卒中急救成绩卓然——不同卒中中心在卒中患者分流情况对比

实施综合卒中中心分流的院前转运政策与AIS患者EVT率的显著、快速和持续增加有关

Stroke:脑淀粉样血管病的急性卒中患者血管内治疗效果分析

血管内血栓切除术联合或不联合溶栓对伴有CAA的急性缺血性卒中患者都有益,但与较差的功能结局相关。

NEJM:血管内治疗对基底动脉闭塞卒中患者的疗效及安全性研究

对于基底动脉闭塞卒中患者,血管内治疗与标准卒中治疗手段相比,在改善患者预后方面无显著优势,但本试验不排除血管内治疗的实质益处,需要更大规模的试验来确定血管内治疗对基底动脉阻塞性卒中的有效性和安全性。

Lancet Neurology:急性缺血性卒中(BP-TARGET)血管内治疗成功后强化降压的安全性和有效性:一项多中心、开放标签、随机对照试验

急性缺血性卒中的血管内治疗显示出巨大的疗效,再灌注率超过80%。尽管有这种疗效,但超过一半的患者不能达到功能独立。