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Ischemic brain stroke clinical volatility of patients is recognized, especially in the first few hours after admission
.
According to reports, many patients improved before admission
Stroke
However, these pre-hospital fluctuations have not been well described, there is no effective method to determine and quantify the pre-hospital changes, and the relationship between these changes and the acute intervention and outcome is unknown
.
In MaRISS (Slight and Rapid Improvement of Stroke Research), dJose G.
The study mainly reported their characteristics and their relevance to the results
.
In this observational study, a standardized qualitative assessment of pre-hospital fluctuations was obtained.
The study recruited mild ischemic stroke symptoms within 4.
5 hours of onset (National Institutes of Health Stroke Scale [NIHSS] score 0-5 In 100 hospitals participating in the Get With The Guidelines-Stroke quality improvement project
.
According to reports from patients, family members or medical staff, the number of fluctuations, direction, and overall improvement or deterioration are recorded
Collect baseline NIHSS at arrival and 72 hours (if before 72 hours, at discharge), as well as final diagnosis and stroke subtypes
.
The results after 90 days include the modified Rankin Scale, Barthel Index, Stroke Impact Scale 16 and European Quality of Life
diagnosis
The relationship between prehospital fluctuations and changes in hospital NIHSS (admission to 72 hours or discharge) and 90-day results were studied
.
They found that among the 1588 participants, 35.
5% observed pre-hospital fluctuations, including improvement, deterioration, or both
.
25.
35.
The important significance of this study is that it has found that fluctuations in neurological symptoms and signs are common in the pre-hospital environment
.
In the case of controlled admissions to NIHSS and alteplase treatment, pre-hospital improvement was associated with a better 90-day outcome
Fluctuations in neurological symptoms and signs are common in prehospital settings
Original source:
Romano JG, Gardener H, Smith EE, et al.
Frequency and Prognostic Significance of Clinical Fluctuations Before Hospital Arrival in Stroke.
Stroke.
Frequency and Prognostic Significance of Clinical Fluctuations Before Hospital Arrival in Stroke.
Stroke.
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