Journal of Stroke & Cerebrovascular Diseases最新文献_第8页

Burden and risk factors of stroke in Vietnam from 1990 to 2021 – a systematic analysis from global burden disease 2021 1990年至2021年越南卒中负担和危险因素——来自2021年全球负担疾病的系统分析

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-01-16 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108241

Thien Tan Tri Tai Truyen MD , Nhi Le Y Vo MD , Quynh Phuong Vo MD , Tri Cuong Phan , Phuc Nhan Bao Le , Huong-Dung Thi Nguyen MD , Elizabeth Heckard MS , Hailei Liu MD , Trung Quoc Nguyen MD , Thang Huy Nguyen MD , Thanh N. Nguyen MD , Marco Zuin MD , Thach Nguyen MD

Background

Stroke is a leading cause of death in Vietnam. However, a comprehensive analysis of stroke burden remains limited. This study aims to investigate the burden of stroke and various risk factors in Vietnam from 1990 to 2021.

Study design and Methods

We utilized data from the Global Burden of Disease 2021 estimates. For the burden of stroke, we included the following variables as age-standardized rates (ASR) per 100,000 people per year: incidence, prevalence, disability-adjusted life years (DALYs), and mortality. Stroke-related mortality and DALYs associated with 23 risk factors were also analyzed. Trends were analyzed using joinpoint regression analysis.

Results

In 2021, stroke was responsible for 166,954 deaths (Males:96,764; Females:70,190). The ASR for stroke incidence was 203·36 (95%CI: 190·51–271·81) per 100,000 people, exceeding 187·98 in Southeast Asia and 141·55 globally. From 1990 to 2021, stroke incidence, death, and DALYs decreased steadily, with average annual percentage changes (AAPCs) of -0·34%, -0·49%, and -0·61%. The prevalence of stroke decreased among women (AAPC:-0·19%) and increased among men (AAPC:0·26%). Metabolic risks were the largest contributors to stroke-related mortality (144·89 per 100,000) and DALYs (2,872·37 per 100,000). The analysis revealed that behavioral risks were more prevalent in males, and metabolic risks in females.

Conclusion

Stroke is the leading cause of death and disability in Vietnam. Although its overall burden has declined, the persistent and significant burden among males, coupled with specific risk factors, remains a major concern. Further researches are warranted to develop targeted interventions addressing the distinct risk factors.

背景：中风是越南的主要死亡原因。然而，对中风负担的全面分析仍然有限。本研究旨在调查1990年至2021年越南卒中负担及各种危险因素。研究设计和方法：我们使用了2021年全球疾病负担估计的数据。对于中风的负担，我们纳入了以下变量作为每年每10万人的年龄标准化率（ASR）：发病率、患病率、残疾调整生命年（DALYs）和死亡率。还分析了卒中相关死亡率和与23个危险因素相关的伤残调整寿命。趋势分析采用连接点回归分析。结果：2021年，中风导致166,954人死亡(男性：96,764；女性:70190)。卒中发病率的ASR为每10万人203.36 (95%CI: 190.51 ~ 270.81)，东南亚超过187.98，全球超过141.55。从1990年到2021年，脑卒中发病率、死亡率和DALYs稳步下降，年均百分比变化（AAPCs）分别为- 0.34%、- 0.49%和- 0.61%。女性卒中患病率下降（AAPC:- 0.19%），男性卒中患病率上升（AAPC: 0.26%）。代谢风险是卒中相关死亡率（每10万人144·89人）和DALYs（每10万人2872·37人）的最大贡献者。分析显示，行为风险在男性中更为普遍，而代谢风险在女性中更为普遍。结论：中风是越南死亡和残疾的主要原因。虽然其总体负担有所下降，但男性持续和沉重的负担，加上具体的危险因素，仍然是一个主要问题。需要进一步的研究来制定针对不同危险因素的有针对性的干预措施。

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引用次数: 0

Association of antihypertensive drug target genes with stroke subtypes: A Mendelian randomization study 降压药靶基因与脑卒中亚型的关联：孟德尔随机研究

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-01-16 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108244

He Zheng , Wenbin Wang , Weida Qiu , Yingqing Feng

Objective

Epidemiological and genetic studies have elucidated the effect of antihypertensive medication (AHM) on stroke subtypes varying upon drug classes, but which drug target genes, how, and where mediated this association remains unknown. We aimed to investigate the impact of AHM on stroke subtypes.

Methods

Genetic instruments for the expression of AHM target genes were identified with expression quantitative trait loci in blood, which should be associated with systolic blood pressure (SBP) to proxy for the effect of AHM. Sensitivity analysis, including reverse causality detection, horizontal pleiotropy, phenotype scanning, tissue enrichment analyses, Bayesian colocalization, and linkage disequilibrium check, were utilized to validate our findings.

Results

A 1-standard deviation (SD) decrease of KCNJ11 gene expression (acting on arteriolar smooth muscle) was associated with a decrease of 2.19 (95 % confidence interval (CI), 1.67-2.71) mmHg of SBP, and a decreased risk of stroke subtypes (Any stroke: odds ratio (OR): 0.80, 95 % CI: 0.70-0.90; Ischemic stroke: OR, 0.79; 95 % CI, 0.69-0.90), respectively. Similarly, a negative association was found between the gene expression of ADRB1 and the risk of small vessel stroke (SVS) (OR, 0.61; 95 % CI, 0.49-0.75). Colocalization supported the probability of shared causal variants for the KCNJ11 and ADRB1 genes in different stroke subtypes. NHLRC2, the nearby gene of ADRB1, was also associated with a higher risk of SVS.

Conclusion

Our study implies that changes in expression of KCNJ11 and ADRB1 mediated possibly via AHM may decrease stroke subtypes’ risk and NHLRC2 is a potential therapy target gene of SVS.

目的：流行病学和遗传学研究已经阐明了抗高血压药物（AHM）对不同药物类别的卒中亚型的影响，但哪种药物靶向基因，如何以及在何处介导这种关联仍然未知。我们的目的是研究AHM对脑卒中亚型的影响。方法：确定AHM靶基因表达的遗传工具，在血液中表达数量性状位点，与收缩压（SBP）相关，代表AHM的作用。敏感性分析，包括反向因果关系检测、水平多效性、表型扫描、组织富集分析、贝叶斯共定位和连锁不平衡检查，用于验证我们的发现。结果：KCNJ11基因表达（作用于小动脉平滑肌）每降低1个标准差（SD），收缩压降低2.19(95%可信区间（CI）， 1.67-2.71) mmHg，卒中亚型风险降低(任何卒中：优势比（OR）： 0.80, 95% CI: 0.70-0.90；缺血性卒中：OR为0.79；95% CI, 0.69-0.90)。同样，ADRB1基因表达与小血管卒中（SVS）风险呈负相关(OR, 0.61；95% ci, 0.49-0.75)。共定位支持了KCNJ11和ADRB1基因在不同卒中亚型中共享因果变异的可能性。ADRB1的邻近基因NHLRC2也与SVS的高风险相关。结论：本研究提示可能通过AHM介导的KCNJ11和ADRB1的表达变化可降低脑卒中亚型的风险，NHLRC2是SVS潜在的治疗靶基因。

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引用次数: 0

Comparison of the associations between life's essential 8 and life's simple 7 with stroke: NHANES 1999–2018 生命的本质和简单与中风之间关系的比较：NHANES 1999-2018。

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-01-12 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108238

Ye Yuan Phd , Peng Tian Phd , Laifu Li Phd , Qiumin Qu MD, Phd

Objective

This study aims to explore the association between Life's Essential 8 (LE8) and stroke and all-cause mortality, and compare whether it has an advantage over Life's Simple 7 (LS7).

Methods

This study investigated data from NHANES spanning from 1999 to 2018. The LE8 was categorized as low, moderate and high cardiovascular health (CVH). LS7 score was categorized as inadequate, average, or optimal. Weighted logistic regression and restricted cubic spline (RCS) were used to examin correlations. Receiver operating characteristic (ROC) curves were employed to detect the accuracy in predicting stroke. The stratified and sensitivity analyses were conducted along with mediation analysis. In addition, a longitudinal cohort was constructed by combining the mortality data, and Cox regression models were utilized to determine the association between CVH and the mortality rate.

Results

For LE8, compared to low CVH, moderate CVH was associated with a 41 % lower risk of stroke, and high CVH was associated with a 71 % lower prevalence of stroke. For LS7, compared to inadequate CVH, average CVH was associated with a 24 % lower prevalence of stroke, and optimal CVH was associated with a 39 % lower prevalence of stroke. RCS showed inverse dose-response relationships of both LE8 and LS7 with stroke. In unweighted ROC, LE8 (AUC = 0.702, 95 % CI: 0.685-0.718, P < 0.001) has a stronger ability to discriminate stroke than LS7 (0.677, 95 % CI: 0.658-0.696, P < 0.001) (P_DeLong = 0.046). Sensitivity analyses demonstrated robustness of LE8 in predicting stroke. GGT and WBC mediated 4.92 % and 4.58 % of the association, respectively. Cox regression showed neither LE8 nor LS7 were predictive of mortality risk among stroke survivor.

Conclusions

LE8 outperformed LS7 in classifying stroke. Oxidative stress and inflammation mediated the association between LE8 and stroke.

目的：本研究旨在探讨Life's Essential 8 （LE8）与卒中及全因死亡率的关系，并比较其是否优于Life's Simple 7 （LS7）。方法：本研究调查了1999年至2018年NHANES的数据。LE8分为低、中、高心血管健康（CVH）。LS7评分分为不足、平均或最佳。使用加权逻辑回归和限制三次样条（RCS）来检验相关性。采用受试者工作特征（ROC）曲线检测脑卒中预测的准确性。在进行中介分析的同时进行分层和敏感性分析。此外，结合死亡率数据构建纵向队列，利用Cox回归模型确定CVH与死亡率的相关性。结果：对于LE8，与低CVH相比，中度CVH与卒中风险降低41%相关，高CVH与卒中患病率降低71%相关。对于LS7，与CVH不足相比，平均CVH与卒中患病率降低24%相关，最佳CVH与卒中患病率降低39%相关。RCS显示LE8和LS7与脑卒中呈负剂量反应关系。在未加权ROC中，LE8 （AUC=0.702, 95% CI: 0.685-0.718, PDeLong=0.046）。敏感性分析显示LE8预测脑卒中的稳健性。GGT和WBC分别介导了4.92%和4.58%的相关性。Cox回归分析显示，LE8和LS7均不能预测脑卒中幸存者的死亡风险。结论：LE8在脑卒中分类上优于LS7。氧化应激和炎症介导LE8与中风之间的关系。

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引用次数: 0

Association between systemic inflammatory response index and cerebral small vessel disease 全身炎症反应指数与脑血管病的关系

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-01-12 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108237

Ting Zhuang , Xiao Xu , Peiyu Huang , Yuqin Zhang

Objective

This study aimed to explore the relationship between the Systemic Inflammatory Response Index (SIRI) and Cerebral Small Vessel Disease (CSVD), focusing on its key imaging markers.

Methods

We enrolled 344 patients admitted to the neurology department between January 2022 and September 2024, comprising 223 patients diagnosed with CSVD and 121 without CSVD. Baseline characteristics were compared between groups, and multivariate logistic regression was performed to assess the impact of SIRI on CSVD risk. Further, univariate and multivariate logistic regression analyses were conducted to examine the relationship between SIRI and CSVD imaging markers, including White Matter Hyperintensity (WMH), lacunes, Perivascular Space (PVS), and Recent Small Subcortical Infarct (RSSI).

Results

Significant differences were observed between the CSVD and non-CSVD groups in terms of age, sex, history of hypertension, diabetes, white blood cell count, neutrophil count, lymphocyte count, homocysteine levels, and SIRI values. Multivariate analysis confirmed that elevated SIRI is independently associated with an increased risk of CSVD. Additionally, higher SIRI values were linked with more severe CSVD imaging features, including moderate-to-severe WMH, the presence of lacunes, and RSSI.

Conclusion

These findings demonstrate that elevated SIRI is independently associated with both the occurrence of CSVD and the severity of key imaging markers such as WMH, lacunes, and RSSI. This suggests that SIRI could serve as a useful inflammatory marker for assessing CSVD risk and progression.

目的：探讨系统性炎症反应指数（SIRI）与脑血管病（CSVD）的关系，重点探讨其关键影像学指标。方法：我们纳入了2022年1月至2024年9月期间在神经科住院的344例患者，其中223例诊断为CSVD， 121例未诊断为CSVD。比较各组之间的基线特征，并进行多变量逻辑回归来评估SIRI对心血管疾病风险的影响。此外，进行单因素和多因素logistic回归分析，以检验SIRI与CSVD成像标志物之间的关系，包括白质高强度（WMH）、腔隙、血管周围间隙（PVS）和近期皮质下小梗死（RSSI）。结果：CSVD组与非CSVD组在年龄、性别、高血压史、糖尿病史、白细胞计数、中性粒细胞计数、淋巴细胞计数、同型半胱氨酸水平、SIRI值等方面存在显著差异。多变量分析证实，SIRI升高与心血管疾病风险增加独立相关。此外，较高的SIRI值与更严重的CSVD成像特征相关，包括中度至重度WMH、凹窝的存在和RSSI。结论：这些发现表明，SIRI升高与CSVD的发生和关键影像学指标（如WMH、凹窝和RSSI）的严重程度独立相关。这表明SIRI可以作为评估CSVD风险和进展的有用炎症标志物。

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引用次数: 0

Visual outcomes of central retinal artery occlusion: Exploring treatment strategies beyond the conventional time window 视网膜中央动脉闭塞的视力结果：探索超越常规时间窗的治疗策略。

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-01-12 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108240

Chi-Chun Yang , Chang-Chi Weng , Yu-Bai Chou , Yi-Ming Huang , De-Kuang Hwang , Shih-Jen Chen , Tai-Chi Lin

Backgrounds/Aims

Central retinal artery occlusion (CRAO) is a vision-devastating emergency. However, widely-acknowledged treatment consensus is lacking and prehospital delays commonly occur. Hence, we aimed to investigate the visual outcomes of conservative treatments (CT), local intra-arterial fibrinolysis (LIF) and hyperbaric oxygen (HBO) therapy for non-arteritic CRAO (NA-CRAO) patients beyond the conventional time window.

Methods

This retrospective comparative study included 99 NA-CRAO patients followed up for over 6 months. The subjects were divided into three groups: the CT (50 patients), LIF (10 patients) and HBO group (39 patients). The primary endpoint was the best-corrected visual acuity (BCVA) change at 6 months compared to baseline. The secondary endpoint was the improvement in BCVA at 1 year and final visits.

Results

No heterogeneity regarding demographics was identified. However, the HBO group had a more extended time-to-treatment period (median 6.0 days) and more advanced-stage CRAO cases (41 % stage III) than the CT (median 4.0 days, 14 % stage III) and LIF (median 0.6 days, 20 % stage III) groups. Despite this, the HBO group exhibited a significantly greater BCVA and a higher proportion of patients achieving significant vision improvement than those in the CT group at 6-, 12-month and final exams (51.3 % vs. 24.0 %, P < 0.05). The LIF appeared to improve outcomes more than CT over time without significance.

Conclusion

Our study provided a concurrent comparison across 3 approaches and demonstrated that HBO therapy beyond the time window remained more effective in improving vision than CT alone for NA-CRAO patients, which had not been proposed by prior studies.

背景/目的：视网膜中央动脉闭塞症（CRAO）是一种严重损害视力的急症。然而，缺乏广泛认可的治疗共识，院前延误经常发生。因此，我们旨在研究非动脉性CRAO （NA-CRAO）患者在常规时间窗之外的保守治疗（CT）、局部动脉内纤溶（LIF）和高压氧（HBO）治疗的视觉效果。方法：对99例NA-CRAO患者进行回顾性比较研究，随访6个月以上。将患者分为CT组（50例）、LIF组（10例）和HBO组（39例）。主要终点是6个月时与基线相比的最佳矫正视力（BCVA）变化。次要终点是1年和最后一次就诊时BCVA的改善。结果：在人口统计学方面没有发现异质性。然而，与CT组（中位4.0天，14% III期）和LIF组（中位0.6天，20% III期）相比，HBO组有更长的治疗时间（中位6.0天）和更多的晚期CRAO病例（41% III期）。尽管如此，在6个月、12个月和期末检查时，HBO组的BCVA明显高于CT组，获得显著视力改善的患者比例也高于CT组（51.3% vs. 24.0%）。结论：我们的研究提供了3种方法的同时比较，证明了时间窗外的HBO治疗在改善NA-CRAO患者视力方面仍然比单独的CT治疗更有效，这是之前的研究没有提出的。

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引用次数: 0

Cerebral air embolism: Process change with unintended consequences 脑空气栓塞：过程改变与意外后果。

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-01-11 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108225

JJ Baumann MS, RN, CCNS-BC, FNSC , Michelle Hill MS, RN, AGCNS-BC , Amy Swank PharmD, BCPS , Ricky Medel MD, FAANS, FACS, FCNS

Introduction

During a cerebrovascular procedure, diligent care is made to ensure no air is present in lines and connectors. Should air enter the cerebral vasculature, cerebral air emboli can cause worsening neurological outcome or death. This communication outlines how a process change of refrigerating mixed heparin for storage lead to the presence of unintentional air, or off-gassing of the fluid.

Material & method

The off-gassing phenomenon was noted during procedure. Various hypotheses were considered, including fluid preparation and manufacturing defects of lines and tubes. Further investigation identified a new process in mixing of heparin bags that were then refrigerated. The off-gassing was noted during the procedure when cold fluid flowed through tubing draped across a warming blanket.

This article utilizes the explanatory research method to describe the cause and effect relationship. The aim is to provide knowledge of this phenomenon to prevent future occurrences.

Result

Fluids used for neuro endovascular procedures should be warmed to prevent off-gassing, which can lead to cerebral air embolus.

Conclusion

Air formation or out-gassing can occur when cold fluids are warmed. During neuro endovascular procedure, this unintentional air can cause significant morbidity or mortality to the patient. Understanding and recognizing this phenomenon is important to prevent patient harm.

导言：在脑血管手术过程中，要小心确保管路和连接处没有空气。如果空气进入脑血管系统，脑空气栓塞可导致神经系统预后恶化或死亡。本通讯概述了混合肝素冷藏储存过程的变化如何导致无意空气的存在，或流体的废气。材料与方法：在工艺过程中注意到脱气现象。考虑了各种假设，包括线、管和流体制备的制造缺陷。进一步调查发现了一种混合肝素袋并冷藏的新工艺。在操作过程中，当冷流体流过覆盖在暖毯上的油管时，发现了废气。本文运用解释性研究方法来描述二者的因果关系。其目的是提供有关这种现象的知识，以防止今后再次发生。结果：用于神经血管内手术的液体应加热，以防止气体排放导致脑空气栓塞。结论：当冷流体被加热时，会发生空气形成或漏气。在神经血管内手术过程中，这种无意的空气可导致患者显著的发病率或死亡率。理解和认识这一现象对于防止患者受到伤害非常重要。

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引用次数: 0

Serum uric acid levels and intracerebral hemorrhage: A two-sample Mendelian randomization study 血清尿酸水平与脑出血：一项双样本孟德尔随机化研究。

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-01-11 DOI: 10.1016/j.jstrokecerebrovasdis.2024.108192

Buyou Lu , Xiaorui Sun , Qi Zhong , Zijiu Sun

Objective

Previous observational studies have generated controversy regarding the correlation between serum uric acid (UA) levels and intracerebral hemorrhage (ICH), with the causal relationship remaining uncertain. To assess the potential causal relationship between serum UA levels and ICH, two-sample Mendelian randomization analysis was applied.

Methods

Single-nucleotide polymorphisms (SNPs) closely associated with serum UA were retrieved from the genome-wide association study (GWAS) database, including 580,505 individuals of European descent. A total of 27 and 251 SNPs were chosen as instrumental variables. Summary data for ICH included 1935 cases and 471,578 controls. Two-sample MR analyses, including inverse-variance weighted (IVW), MR-Egger, weighted median, and weighted mode methods, were employed to assess the potential causal relationship between serum UA levels and ICH, with odds ratios (ORs) as effect estimates. Heterogeneity was evaluated using Cochran's Q test, and sensitivity analyses were conducted using the leave-one-out method.

Results

The IVW analysis revealed that a 1 mg/dL increase in serum UA was associated with a 16.5 % higher risk of ICH (OR 1.165, 95 % CI 1.01-1.34, P = 0.034), while a 1 quantile increase in serum UA was associated with a 25.9 % higher risk (OR 1.259, 95 % CI 1.091-1.46, P = 0.002). Cochran's Q test showed no evidence of heterogeneity. No horizontal pleiotropy was detected. The sensitivity analysis using the leave-one-out method supported the robustness and reliability of our results.

Conclusion

The study reveals that elevated serum UA levels are causally linked to ICH, suggesting the potential applicability of serum UA as a biomarker for the occurrence of ICH.

目的：以往的观察性研究对血清尿酸（UA）水平与脑出血（ICH）的相关性存在争议，其因果关系尚不确定。为了评估血清尿酸水平与脑出血之间的潜在因果关系，采用双样本孟德尔随机化分析。方法：从全基因组关联研究（GWAS）数据库中检索与血清UA密切相关的单核苷酸多态性（snp），其中包括580,505名欧洲血统个体。共选择27个和251个snp作为工具变量。ICH的汇总数据包括1935例病例和471,578例对照。采用双样本MR分析，包括反方差加权（IVW）、MR- egger、加权中位数和加权模式方法，评估血清UA水平与脑出血之间的潜在因果关系，并以比值比（ORs）作为效果估计。采用Cochran’s Q检验评估异质性，采用留一法进行敏感性分析。结果：IVW分析显示，血清UA升高1 mg/dL与ICH风险增加16.5%相关（OR 1.165, 95% CI 1.01-1.34， P=0.034），而血清UA升高1分位数与ICH风险增加25.9%相关（OR 1.259, 95% CI 1.091-1.46， P=0.002）。科克伦的Q检验没有显示异质性的证据。未发现水平多效性。采用留一法进行敏感性分析，结果具有稳健性和可靠性。结论：本研究表明血清UA水平升高与脑出血有因果关系，提示血清UA作为脑出血发生的生物标志物的潜在适用性。

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引用次数: 0

Letter to the editor regarding “Electroacupuncture improves vascular cognitive impairment no dementia: A randomized clinical trial” 关于“电针改善血管性认知障碍而非痴呆：一项随机临床试验”的致编辑的信。

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-01-10 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108235

Yuxin Wu MD, Yi Liang PhD

引用次数: 0

Sickness absence and disability pension in patients treated with mechanical thrombectomy 机械取栓术患者的病假和伤残抚恤金。

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-01-10 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108236

Mihae Roland MD , Ann-Sofie Rudberg MD, PhD , Fabian Arnberg MD,PhD , Kristina Alexanderson PhD , Christina Sjöstrand MD,PhD

Background

Stroke patients with large vessel occlusions risk long-term or permanent sickness absence. We aimed to analyze the proportions and days of sickness absence and disability pension in thrombectomy-treated patients.

Methods

A register-based nationwide longitudinal cohort study of stroke patients treated with mechanical thrombectomy in 2016-2021 in Sweden (identified through the Swedish Board of Health and Welfare procedural code for care interventions, KVÅ:AAL15). All thrombectomy-treated patients aged 18-63 were followed one year prior and one after stroke. Proportions (%) and number of net days of sickness absence and disability pension were calculated. Predictors for absence were calculated through multinomial regression analysis.

Results

We included 672 patients, mean age was 53 years and 66 % were men. The proportion of patients on sickness absence decreased from 70.4 % at 30 days to 63.2 % at 90 days after stroke onset. Proportions of sickness absence and disability pension did not differ between women and men after treatment. Amongst predictors for having full-time absence at 90 days were: OR (95 % CI) being born in Europe (excl. Nordic countries) 2.17 (1.15-4.11), being single 1.59 (1.12-2.26), elementary education 2.08 (1.21-3.57), and living in a town or suburb 1.47 (1.01-2.14). Patients with no income 0.21 (0.13-0.35) or the lowest income level 0.36 (0.22-0.58) had low odds for full-time sickness absence and disability pension at 90 days.

Conclusions

One third of thrombectomy-treated patients had no sickness absence nor disability pension at day 30 after stroke, and the proportion of patients without absence increased during follow-up. Absence proportions and predictors for full-time absence were centered around income level, educational level, birth country, and type of living area. Notably, there were no sex differences.

背景：脑卒中大血管闭塞患者有长期或永久性疾病缺席的风险。我们的目的是分析血栓切除术患者的病假和伤残抚恤金的比例和天数。方法：对2016-2021年在瑞典接受机械取栓治疗的卒中患者进行基于登记的全国纵向队列研究（通过瑞典卫生和福利委员会护理干预程序代码确定，KVÅ：AAL15）。所有接受血栓切除术的18-63岁患者均在中风前一年和中风后一年进行随访。计算病假和伤残养恤金的比例（%）和净天数。缺席的预测因子通过多项回归分析计算。结果：纳入672例患者，平均年龄53岁，男性占66%。卒中发病后30天缺勤的患者比例从70.4%下降到90天的63.2%。患病缺勤和残疾养恤金的比例在治疗后的男女之间没有差异。全职缺勤90天的预测因素包括：OR （95% CI）出生在欧洲（不包括北欧国家）2.17(1.15-4.11)，单身1.59(1.12-2.26)，小学教育2.08(1.21-3.57)，居住在城镇或郊区1.47（1.01-2.14）。无收入0.21（0.13-0.35）或最低收入水平0.36（0.22-0.58）的患者获得90天全职病假和残疾抚恤金的几率较低。结论：三分之一的取栓患者卒中后第30天无疾病缺勤和残疾养老金，随访期间无缺勤的患者比例增加。全职缺勤的比例和预测因素主要围绕收入水平、教育水平、出生国家和居住区域类型。值得注意的是，没有性别差异。

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引用次数: 0

3DSlicer software-assisted neuroendoscopic surgery compared with traditional surgery on surgical effects, complications, and safety evaluation in patients with intracerebral hemorrhage: A systematic review and meta-analysis 3DSlicer软件辅助神经内窥镜手术与传统手术在脑出血患者手术效果、并发症及安全性评价方面的比较：系统综述和meta分析

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-01-10 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108226

Jin Han , Zhitong Han , Ruijian Zhang , Peng Sun , Yanna Zhang , Yucong Yao

Objective

This study aims to comprehensively evaluate the complications, effectiveness, and safety of neuroendoscopic surgery (NS) assisted by 3DSlicer software, compared to traditional surgery in patients with intracerebral hemorrhage (IH).

Methods

We searched for case-control trials from the Chinese Biomedical Literature data (CBM) online database, Wanfang Database, EMBASE, VIP Full-text Database, China National Knowledge Infrastructure (CNKI), Science Direct, Cochrane Library, and PubMed. The studies, published since January 2010, involved NS or traditional surgery for IH patients assisted by 3DSlicer software. Data were independently retrieved by two researchers, and the risk of bias in each study was evaluated using the Cochrane Handbook 5.3 standard.

Results

A total of 591 patients from seven controlled clinical studies were included. Fixed-effect model analysis revealed a significantly higher treatment effectiveness rate in the study group (SG) (P < 0.05). Random-effects model (REM) analysis indicated that the operation time in the SG was significantly shorter (P < 0.05). Furthermore, the SG group experienced significantly shorter hospitalization time (P < 0.05). NIHSS scores in the SG were notably lower (P < 0.05). Fixed-effect model analysis also showed that the incidence of postoperative complications in the SG was significantly lower (P < 0.05).

Conclusion

Neuroendoscopic surgery assisted by 3DSlicer software is more effective in treating IH, enhancing prognosis, improving neurological function, and reducing complication rates. This approach appears to be a promising candidate for clinical adoption.

目的：综合评价3DSlicer软件辅助下神经内镜手术（NS）治疗脑出血（IH）的并发症、疗效和安全性，并与传统手术进行比较。方法：从中国生物医学文献数据库（CBM）在线数据库、万方数据库、EMBASE、VIP全文数据库、中国知网（CNKI）、Science Direct、Cochrane Library和PubMed中检索病例对照试验。这些研究发表于2010年1月，涉及在3DSlicer软件的辅助下对IH患者进行NS或传统手术。数据由两名研究者独立检索，每项研究的偏倚风险采用Cochrane Handbook 5.3标准进行评估。结果：共纳入7项对照临床研究的591例患者。固定效应模型分析显示，研究组（SG）治疗有效率显著高于对照组（P < 0.05）。随机效应模型（REM）分析显示，手术时间明显缩短（P < 0.05）。SG组住院时间明显缩短（P < 0.05）。对照组NIHSS评分显著低于对照组（P < 0.05）。固定效应模型分析也显示SG术后并发症发生率明显降低（P < 0.05）。结论：3DSlicer软件辅助下的神经内镜手术治疗IH更有效，改善预后，改善神经功能，减少并发症发生率。这种方法似乎是临床采用的有希望的候选方法。

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