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Báo cáo hóa học: " CT angiography predicts use of tertiary interventional services in acute ischemic stroke patients"

Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí hóa hoc quốc tế đề tài : CT angiography predicts use of tertiary interventional services in acute ischemic stroke patients | Thomas et al. International Journal of Emergency Medicine 2011 4 62 http www.intjem.eom content 4 1 62 o International Journal of Emergency Medicine a SpringerOpen Journal ORIGINAL RESEARCH Open Access CT angiography predicts use of tertiary interventional services in acute ischemic stroke patients I I rm E I I V V I s f 1 I f I I I m l I rd I r f it k1D ml_I i 1 1 m S-. I s I . 12 7 ĩ I r I m fs m z t 3 A 1r I V fs r 2 I I_I C hi A rm m m 4 m I Lisa E Ihomas Joshua N Goldstein Reza riaKimeiani Yucniao Chang Albert J Yoo Lee H schwamm ana R Gilberto Gonzalez2 Abstract Background Patients with acute stroke are often transferred to tertiary care centers for advanced interventional services. We hypothesized that the presence of a proximal cerebral artery occlusion on CT angiography CTA is an independent predictor of the use of these services. Methods We performed a historical cohort study of consecutive ischemic stroke patients presenting within 24 h of symptom onset to an academic emergency department who underwent emergent CTA. Use of tertiary care interventions including intra-arterial IA thrombolysis mechanical clot retrieval and neurosurgery were captured. Results During the study period 207 290 71 of patients with acute ischemic stroke underwent emergent CTA. Of the patients 74 207 36 showed evidence of a proximal cerebral artery occlusion and 22 207 11 underwent an interventional procedure. Those with proximal occlusions were more likely to receive a neurointervention 26 vs. 2 p 0.001 . They were more likely to undergo IA thrombolysis 9 vs. 0 p 0.001 or a mechanical intervention 19 vs. 0 p 0.0001 but not more likely to undergo neurosurgery 5 vs. 2 p 0.2 . After controlling for the initial NIH stroke scale NIHSS score proximal occlusion remained an independent predictor of the use of neurointerventional services OR 8.5 95 CI 2.2-33 . Evidence of proximal occlusion on CTA predicted use of neurointervention with sensitivity of 82 95 CI 59-94 specificity of 71 95 .