文摘
摘要目的:开发一个临床决策工具确定血管内治疗患者在高资格的可能性(EVT)转移到一个全面的中风研究中心(CSC)。
背景:大约一半的转移急性缺血性中风患者资格EVT在主中风中心(PSC)不接受腹股沟穿刺在CSC到达。确切的患者基线特征预测腹股沟穿刺是未知的。
设计/方法:我们回顾了连续数据从急性中风患者转移到CSC EVT评估在一个区域网络在加拿大,在08/2015和07/2019。临床、影像学和驾驶距离变量进行了探讨。我们进行多变量逻辑回归和最小绝对收缩和选择算子逻辑回归建模与数据分为推导(203名患者)和验证组(67例)。主要结果腹股沟穿刺和血栓切除术的到来。
结果:270转急性缺血性中风患者(平均年龄69.4 + /−13.7,47.4%的女性),201(74.4%)接受了腹股沟穿刺和182年(67.4%)接受血栓切除术。积极预测接受腹股沟穿刺onset-to-PSC到达时间(比值比(或)1.12,95%可信区间(CI) 1.06 - -1.18, p = 0.00004),颈内动脉(ICA)闭塞(或2.74,95%可信区间1.42 - -5.31,p = 0.003),和M1闭塞(或2.48,95%可信区间1.31 - -4.70,p = 0.006)。唯一的负面预测是onset-to-CSC到达时间(或0.91,95%可信区间0.87 - -0.96,p = 0.0002)。这些预测也应用于血栓切除术。我们的腹股沟穿刺和血栓切除术模型有一个C统计推导群分别为0.843和0.810,和0.744和0.667分别验证队列。
结论:延迟提交的PSC, ICA和M1遮挡预测更高概率的腹股沟穿刺和血栓切除术,而再传输时间CSC概率较低有关。这个预测模型可以指导医生选择基于pre-transfer EVT的候选传输数据。
披露:陈竺没有披露。尤安张没有披露。Clifford是受到个人薪酬在500 - 4999美元的范围作为麦克马斯特大学的顾问。克利福德是已经收到了麦克马斯特大学的研究支持。Kim Kwang Hyun没有披露。Aristeidis Katsanos没有披露。朗达怀特曼没有披露。Oczkowski博士没有披露。Kanjana佩雷拉没有披露。开尔文Ng已收到个人薪酬在5000 - 9999美元的范围为Abbvie担任顾问。 The institution of Kelvin Ng has received research support from CaSTOR. Dr. Shoamanesh has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer AG. Dr. Shoamanesh has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Daiichi Sankyo . Dr. Shoamanesh has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Servier Inc.. Dr. Shoamanesh has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurodiem.ca. The institution of Dr. Shoamanesh has received research support from Servier Canada Inc.. The institution of Dr. Shoamanesh has received research support from Daiichi Sankyo Ltd.. The institution of Dr. Shoamanesh has received research support from Bayer AG. The institution of Dr. Shoamanesh has received research support from Bristol-Myers Squibb. The institution of Dr. Shoamanesh has received research support from Octapharma Canada . Dr. Catanese has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for IschemiaCare.
