Ling Feng, Yueyue He, Shuju Dong, Rui Wang, Shiyan Long, Li He
{"title":"急性缺血性脑卒中机械取栓后90天预后的探索性描述性队列研究。","authors":"Ling Feng, Yueyue He, Shuju Dong, Rui Wang, Shiyan Long, Li He","doi":"10.1080/10376178.2022.2107038","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the relationship between nursing assessment findings at discharge and acute ischaemic stroke (AIS) patient prognosis after mechanical thrombectomy (MT).</p><p><strong>Methods: </strong>We analysed the characteristics of 144 AIS patients with MT treatment admitted to a university affiliated teaching hospital in Chengdu, Sichuan Province China, from January 2020 to December 2020. The modified Rankin Scale (mRS) score was used to assess outcomes 90-days after discharge. Exploratory analyses were undertaken using IBM SPSS Statistics (Version 26.0).</p><p><strong>Results: </strong>At 90-days, 47.9% (<i>n</i> = 69) had a good prognosis (mRS ≤ 2) including 22.2% (<i>n</i> = 32) fully recovered patients. There were 5 (3.5%) deceased patients and 48.6% (<i>n</i> = 70) of patients had a poor prognosis (mRS ≥ 3). In univariate analysis, clinical prognosis correlated with the need for inpatient endotracheal intubation (<i>p</i> = 0.02), nasogastric tube (<i>p < </i>0.001), indwelling urinary catheter (<i>p < </i>0.001), central venous catheter (<i>p </i>= 0.03), health knowledge needs of pressure injury prevention (<i>p </i>= 0.03), National Institute of Health Stroke Scale (NIHSS) score (<i>p < </i>0.001) and Activities of Daily Living (ADL) score (<i>p < </i>0.001) at the time of discharge from hospital. The average hospitalization time of the 144 patients was 12[IQR, 9-25] days, and the average cost of hospitalization was $Y$21291.93 (SD 9165.01).</p><p><strong>Conclusion: </strong>Almost half of the surviving patients had a poor prognosis. In our country, this surgery and rehabilitation impose a significant financial burden that needs to be addressed. However, the longer length of hospital stay and higher costs at discharge may be contributing factors to worse outcomes. The outcomes of comprehensive nursing assessment of the patients, including nursing needs, activities of daily living, and neurological function, can predict their outcome.</p><p><strong>Impact statement: </strong>We recommend a comprehensive nursing assessment at discharge that predicts patient outcomes and can be used for subsequent targeted interventions. The prognosis of patients with acute ischaemic stroke after mechanical thrombectomy is poor, and the financial burden needs to be considered.</p>","PeriodicalId":55633,"journal":{"name":"Contemporary Nurse","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"An exploratory descriptive cohort study of 90-day prognosis after acute ischaemic stroke with mechanical thrombectomy.\",\"authors\":\"Ling Feng, Yueyue He, Shuju Dong, Rui Wang, Shiyan Long, Li He\",\"doi\":\"10.1080/10376178.2022.2107038\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>To evaluate the relationship between nursing assessment findings at discharge and acute ischaemic stroke (AIS) patient prognosis after mechanical thrombectomy (MT).</p><p><strong>Methods: </strong>We analysed the characteristics of 144 AIS patients with MT treatment admitted to a university affiliated teaching hospital in Chengdu, Sichuan Province China, from January 2020 to December 2020. The modified Rankin Scale (mRS) score was used to assess outcomes 90-days after discharge. Exploratory analyses were undertaken using IBM SPSS Statistics (Version 26.0).</p><p><strong>Results: </strong>At 90-days, 47.9% (<i>n</i> = 69) had a good prognosis (mRS ≤ 2) including 22.2% (<i>n</i> = 32) fully recovered patients. There were 5 (3.5%) deceased patients and 48.6% (<i>n</i> = 70) of patients had a poor prognosis (mRS ≥ 3). In univariate analysis, clinical prognosis correlated with the need for inpatient endotracheal intubation (<i>p</i> = 0.02), nasogastric tube (<i>p < </i>0.001), indwelling urinary catheter (<i>p < </i>0.001), central venous catheter (<i>p </i>= 0.03), health knowledge needs of pressure injury prevention (<i>p </i>= 0.03), National Institute of Health Stroke Scale (NIHSS) score (<i>p < </i>0.001) and Activities of Daily Living (ADL) score (<i>p < </i>0.001) at the time of discharge from hospital. The average hospitalization time of the 144 patients was 12[IQR, 9-25] days, and the average cost of hospitalization was $Y$21291.93 (SD 9165.01).</p><p><strong>Conclusion: </strong>Almost half of the surviving patients had a poor prognosis. In our country, this surgery and rehabilitation impose a significant financial burden that needs to be addressed. However, the longer length of hospital stay and higher costs at discharge may be contributing factors to worse outcomes. The outcomes of comprehensive nursing assessment of the patients, including nursing needs, activities of daily living, and neurological function, can predict their outcome.</p><p><strong>Impact statement: </strong>We recommend a comprehensive nursing assessment at discharge that predicts patient outcomes and can be used for subsequent targeted interventions. The prognosis of patients with acute ischaemic stroke after mechanical thrombectomy is poor, and the financial burden needs to be considered.</p>\",\"PeriodicalId\":55633,\"journal\":{\"name\":\"Contemporary Nurse\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2022-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Contemporary Nurse\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/10376178.2022.2107038\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/9/19 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Contemporary Nurse","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/10376178.2022.2107038","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/9/19 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"NURSING","Score":null,"Total":0}
An exploratory descriptive cohort study of 90-day prognosis after acute ischaemic stroke with mechanical thrombectomy.
Aim: To evaluate the relationship between nursing assessment findings at discharge and acute ischaemic stroke (AIS) patient prognosis after mechanical thrombectomy (MT).
Methods: We analysed the characteristics of 144 AIS patients with MT treatment admitted to a university affiliated teaching hospital in Chengdu, Sichuan Province China, from January 2020 to December 2020. The modified Rankin Scale (mRS) score was used to assess outcomes 90-days after discharge. Exploratory analyses were undertaken using IBM SPSS Statistics (Version 26.0).
Results: At 90-days, 47.9% (n = 69) had a good prognosis (mRS ≤ 2) including 22.2% (n = 32) fully recovered patients. There were 5 (3.5%) deceased patients and 48.6% (n = 70) of patients had a poor prognosis (mRS ≥ 3). In univariate analysis, clinical prognosis correlated with the need for inpatient endotracheal intubation (p = 0.02), nasogastric tube (p < 0.001), indwelling urinary catheter (p < 0.001), central venous catheter (p = 0.03), health knowledge needs of pressure injury prevention (p = 0.03), National Institute of Health Stroke Scale (NIHSS) score (p < 0.001) and Activities of Daily Living (ADL) score (p < 0.001) at the time of discharge from hospital. The average hospitalization time of the 144 patients was 12[IQR, 9-25] days, and the average cost of hospitalization was $Y$21291.93 (SD 9165.01).
Conclusion: Almost half of the surviving patients had a poor prognosis. In our country, this surgery and rehabilitation impose a significant financial burden that needs to be addressed. However, the longer length of hospital stay and higher costs at discharge may be contributing factors to worse outcomes. The outcomes of comprehensive nursing assessment of the patients, including nursing needs, activities of daily living, and neurological function, can predict their outcome.
Impact statement: We recommend a comprehensive nursing assessment at discharge that predicts patient outcomes and can be used for subsequent targeted interventions. The prognosis of patients with acute ischaemic stroke after mechanical thrombectomy is poor, and the financial burden needs to be considered.
期刊介绍：
Contemporary Nurse is an international peer-reviewed journal designed to increase nursing skills, knowledge and communication, assist in professional development and to enhance educational standards by publishing stimulating, informative and useful articles on a range of issues influencing professional nursing research, teaching and practice.
Contemporary Nurse is a forum for nursing educators, researchers and professionals who require high-quality, peer-reviewed research on emerging research fronts, perspectives and protocols, community and family health, cross-cultural research, recruitment, retention, education, training and practitioner perspectives.
Contemporary Nurse publishes original research articles, reviews and discussion papers.
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