Abstract:
Purpose:To investigate the differences in endovascular thrombectomy (EVT) outcomes of patients treated for acute ischaemic stroke (AIS) during business versus off-business hours. Methods: A single-centre retrospective cohort study of patients with AIS treated with EVT from February 1, 2015, to May 31, 2021, was performed at a comprehensive stroke centre (CSC). Patients were divided into business (Monday to Friday, 8 AM-5 PM) versus off-business hours groups. The primary outcome was functional neurological disability, scored using the modified Rankin Scale (mRS) at 90 days. Secondary outcomes included the rate of successful reperfusion and procedural workflow time delays. Differences in proportions were assessed using Fisher\'s exact and Chi-Square tests as appropriate. For continuous variables, differences in medians between groups were assessed using Mann-Whitney U tests. Results: A total of 676 patients were included, with 399 patients (59%) comprising the off-business-hour group. No significant differences were seen in age, sex, ASPECTS score, or NIHSS at arrival. Off-business hours strokes had a longer delay between CSC arrival to groin puncture (minutes: 81 vs 44, P < .0001) and between imaging to groin puncture (minutes: 67 vs 32, P < .0001) compared to the business hours strokes. There were no differences in the rate of successful reperfusion (mTICI ≥2b) between groups (82% vs 83%, P = .61). At 90 days, 65% of patients in both groups had an mRS ≤2 (P = .91). Conclusion: Despite workflow delays in initiating EVT during off-business hours, there were no differences in the rate of successful reperfusion or functional outcomes.
摘要:
目的:探讨急性缺血性卒中(AIS)患者在营业时间和非营业时间血管内血栓切除术(EVT)结果的差异。方法:对2015年2月1日至2021年5月31日接受EVT治疗的AIS患者进行了一项单中心回顾性队列研究,该研究在综合卒中中心(CSC)进行。患者被划分为业务(周一至周五,上午8点至下午5点)与非营业时间组。主要结果是功能性神经残疾,在90天使用改良的Rankin量表(mRS)进行评分。次要结果包括再灌注成功率和手术工作流程时间延迟。适当时使用Fisher精确和卡方检验评估比例差异。对于连续变量,组间中位数的差异使用Mann-WhitneyU检验进行评估.结果:共纳入676例患者,399名患者(59%)组成非营业时间组。在年龄上没有看到显著差异,性别,各方面得分,或NIHSS在抵达。与营业时间中风相比,非营业时间中风在CSC到达至腹股沟穿刺之间(分钟:81vs44,P<0.0001)和成像至腹股沟穿刺之间(分钟:67vs32,P<0.0001)之间的延迟更长。两组之间的再灌注成功率(mTICI≥2b)没有差异(82%vs83%,P=.61)。90天,两组中65%的患者mRS≤2(P=.91)。结论:尽管在非营业时间启动EVT的工作流程延迟,再灌注成功率或功能结局无差异.