院内缺血性卒中的诊疗现状与挑战

院内卒中是指因其他疾病住院的患者在住院期间发生的急性卒中,其中最常见的类型是缺血性卒中.与社区卒中相比,院内缺血性卒中的危险因素和发病机制更为复杂,除了栓塞、低灌注、高凝状态,医源性因素也是重要的致病原因之一.院内缺血性卒中患者的不良功能预后和死亡率均较社区患者显著增高,研究提示基础疾病较多、围手术期栓塞所致脑梗死范围...

Current Status and Challenges of In-hospital Ischemic Stroke Care

In-hospital stroke is defined as new-onset acute stroke occurring in hospitalized patients admitted for other disease diagnosis or procedure. The most common stroke subtype is in-hospital ischemic stroke. The risk factors and mechanism of in-hospital ischemic stroke are more complex than community-onset stroke. In addition to thromboembolism, hypoperfusion and hypercoagulability, iatrogenic complications of procedures are also one of the important causes. Patients with in-hospital stroke have worse outcomes and higher mortality than patients with community-onset stroke. The multiple comorbidities, larger volume infarct due to embolism and lower reperfusion rate were key factors for poor prognosis. Early identification of in-hospital stroke and timely initiation of stroke fast tract are important factors affecting the treatment effect, which are also the focus of the construction of in-hospital stroke emergency system; in addition, improving the rate of reperfusion therapy in perioperative patients is also an important aspect in the construction of in-hospital stroke emergency system. The procedure and system of in-hospital stroke care in China need to be improved, which need more multi-center study evidence to support for establishing and improving in-hospital ischemic stroke care system, so as to increase the reperfusion rate and improve the prognosis of patients.