【摘要】 目的探讨组织化医疗对住院卒中患者卒中病死率的影响。方法对连云港市第一人民医院神经内科建立卒中单元时段(2007年3月至2010年12月)收治的缺血性卒中患者(SU组,2147例)与未建立卒中单元时段(2004年3月至2007年2月)收住的缺血性卒中患者(NSU组,1674例)按年龄分层后进行对照研究,评估其病死率与死亡风险。采用非参数检验分析各年龄段病死率,并比较和报告相对风险、绝对风险(AR)及95%可信区间(95%CI)、相对风险降、绝对风险降和需治疗数。分类参数采用χ2检验,基线值的等级差异比较用Kruskal-Wallis检验。用SAS 9.13软件完成。结果全组3821例,发病30 d共死亡315例,总体病死率为8.2%。其中,NSU组为175例(10.5%),SU组为140例(6.4%)。两组间差异具有统计学意义(χ2=2.8362,P=0.0008)。所有年龄组发病30 d的AR值差异无统计学意义(45~60岁以下AR=0.62,60~70岁以下AR=0.53,70~80岁以下AR=0.58,80~93岁AR=0.57,P>0.05)。排除性别、卒中类型、溶栓比率及其合并症等影响病死率的因素后,其结果一样。结论组织化卒中医疗是一项行之有效的卒中管理模式,具有显著降低住院卒中患者病死率和死亡风险的作用。更多还原

【Abstract】 Objective To investigate effects of mortality of hospitalized patients associated with organized stroke care. Methods The data of hospitalized patients with ischemic stroke in the period from March 2007 to December 2010 with established stroke unit( group SU,2147 cases) and the data of the period from March 2004 to February 2007 with the non-established stroke unit( group NSU,1674 cases) were collected and comparatively analysized. Results The whole group had 3821 cases,and a total death on onset30 days was 315 cases with 8. 2% of the overall fatality rate. Among them,175 cases( 10. 5%) in the group NSU and 140 cases( CFR 6. 4%) in SU group. The difference of the two groups was statistically significant( χ2= 2. 8362,P = 0. 0008). The absolute risk( AR) of 30 days in all age groups were not statistically significant( AR =0. 62 in group 45 to under 60 years old,AR =0. 53 in group 60 to under 70 years old,AR =0. 58 in group 70 to under 80 years old,AR = 0. 57 in group 80 to 93 years old,P > 0. 05). When all factors affecting mortality were removed,it showed the same results. Conclusions The organized stroke care is an effective management mode,and it has a significant role to reduce mortality and the risk of death in hospitalized stroke patients.更多还原