国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

《国家中心数据管理与共享系统操作说明书 —— 研究者部分》

Thrombolysis, Time-to-Treatment and In-Hospital Outcomes Among Young Adults with Ischemic Stroke in China: Findings from a Nationwide Registry Study in China

第一作者：Haiyan Wang,Hongqiu Gu

通讯作者：Yong Jiang

ischemic stroke young stroke thrombolysis door-to-needle time

基本信息

2022-06-24

已发表文章

发表杂志：BMJ open

发表类型: Original Research

影响因子(IF): 3.006

PMID: 35750455 Pubmed原文链接 全文下载

主要研究背景及目的

To determine whether young adults (< 50 years) with acute ischemic stroke (AIS) are more likely to receive intravenous recombinant tissue plasminogen activator (IV tPA) and have shorter door-to-needle time (DNT).

方法

We analyzed data from the Chinese Stroke Center Alliance (CSCA) registry for AIS patients hospitalized between August 2015 and July 2019. Patients were classified into two groups according to age: young adults (< 50 years of age) and older adults (≥ 50 years of age).

结论

Young adults with AIS were more likely to receive IV tPA than older adults, though there was no difference between the two groups in time to treatment. Compared with older adults, young adults may had better in-hospital outcomes.

主要结果

Of 793 175 patients with AIS admitted to 1471 hospitals, 9.1% (71 860) were young adults. Compared to older adults, a higher proportion of young adults received IV tPA among patients without contraindicaitons (7.2% vs. 6.1%, adjusted odds ratio [aOR] 1.13, 95% confidence interval [CI] 1.10-1.17) and among patients without contraindications and with onset-to-door time ≤3.5h (23.6 % vs. 19.3%, aOR 1.20, 95% CI 1.15-1.24). We did not observe differences in onset-to-needle time (median hours 2.7h) or door-to-needle time (DNT) (median minutes 60m) between young and older adults. The proportion of DNT≤30 minutes, DNT≤45 minutes, and DNT≤60 minutes in young and older IV tPA treated patients were 16.9% vs 18.8%, 30.2% vs 32.8% and 50.2% vs 54.2%, respectively. Compared to older adults, young adults treated with IV tPA had lower odds of in-hospital mortality (0.5% vs 1.3%, aOR 0.54, 95% CI 0.35-0.82) and higher odds of independent ambulation at discharge (61.0% vs 53.6%, aOR 1.15, 95% CI 1.08-1.22), and the associations may be partly explained by stroke severity measured by NIHSS score.