老年急性脑卒中患者就诊至溶栓时间延误及其相关因素分析  

Analysis of delay of door-to-needle time in elderly patients with acute ischemic stroke and its related factors

作　　者：刘君利 崔杨慧 沈连华 杨晓丽 Liu Junli;Cui Yanghui;Shen Lianhua;Yang Xiaoli(Department of Emergency,People’s Hospital of Hai an City,Hai an,Jiangsu,226600,P.R.China;Department of Neurology,People’s Hospital of Hai an City,Hai an,Jiangsu,226600,P.R.China)

机构地区：[1]海安市人民医院急诊科,江苏海安226600 [2]海安市人民医院神经内科,江苏海安226600

出　　处：《老年医学与保健》2024年第1期57-60,83,共5页Geriatrics & Health Care

摘　　要：目的探讨老年急性脑卒中(AIS)患者就诊至溶栓时间(door-to-needle time,DNT)延误情况及相关因素,旨在为优化AIS的救治工作提供依据。方法回顾性纳入2022年1月—2023年1月于海安市人民医院收治的89例老年AIS患者作为研究对象,收集一般资料,将入组患者分为延误组(DNT>60 min,n=33)与非延误组(DNT≤60 min,n=56)。采用单因素、多因素Logistic回归分析影响老年AIS患者DNT延误的相关因素。结果延误组DNT明显长于非延误组[(85.16±10.29)min vs(40.53±12.58)min,P<0.05)]。延误组与非延误组在发病至入院时间、入院至生化检查时间、影像学完成检查时间、知情同意耗时、入院时NIHSS评分、就诊时间段差异均有统计学意义(P均<0.05)。单因素Logistic回归分析显示,发病至入院时间、入院至生化检查时间、影像学完成检查时间、知情同意耗时、入院时NIHSS评分、就诊时间段均为影响老年AIS患者DNT延误的相关因素(P均<0.05)。多因素Logistic回归分析显示,发病至入院时间缩短、影像学完成检查时间增加、知情同意耗时增加和入院时NIHSS评分增加均为影响老年AIS患者DNT延误的独立危险因素(OR=2.085、2.195、2.255和2.179)(P均<0.05)。结论老年AIS患者DNT延误较为常见,其原因可能主要与发病至入院时间、影像学完成检查时间、知情同意耗时和入院时NIHSS评分增加有关。Objective To explore the delay of door-to-needle time(DNT)and its related factors in elderly patients with acute ischemic stroke(AIS),and provide a basis for the optimization of AIS treatment.Methods A total of 89 elderly AIS patients admitted to People s Hospital of Hai an City from January 2022 to January 2023 were retrospectively included as the study subjects.Their general data were collected.According to DNT,they were divided into delay group(DNT>60 min,n=33)and non-delay group(DNT≤60 min,n=56).The univariate and multivariate Logistic regression analysis were used to identify the relevant factors affecting DNT delay in elderly AIS patients.Results DNT in the delay group was significantly longer than that in the non-delay group[(85.16±10.29)min vs(40.53±12.58)min,P<0.05].There were significant differences in the time from onset to admission,time from admission to biochemical examination,completion time of imaging examination,informed consent time,NIHSS score at admission and visit time period between the two groups(P<0.05).Univariate Logistic regression analysis showed that time from onset to admission,time from admission to biochemical examination,completion time of imaging examination,informed consent time,NIHSS score at admission and visit time period were all related factors affecting DNT delay in elderly patients with AIS(P<0.05).Multivariate logistic regression analysis showed that shortened time from onset to admission,prolonged completion time of imaging examination and informed consent time,and increased NIHSS score at admission were all independent risk factors for DNT delay in elderly AIS patients(OR=2.085,2.195,2.255,2.179);(P<0.05).Conclusion DNT delay is more common in elderly AIS patients,which may be mainly related to the increase in the time from onset to admission,completion time of imaging examination,informed consent time and NIHSS score at admission.

关 键 词：老年 急性脑卒中 就诊至溶栓时间 院内延误 相关因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]