Access to mechanical thrombectomy for cerebral ischaemia: A population-based study in the North-of-France
| Autor: | F. Mounier-Vehier, Caroline Moreau, Solène Moulin, Isabelle Girard-Buttaz, Charlotte Cordonnier, Didier Leys, Marc Ferrigno, Romain Tortuyaux, Maxime Chochoi, Nelly Dequatre-Ponchelle, J.-P. Pruvo, Hilde Hénon, Barbara Casolla, Patrick Goldstein |
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| Přispěvatelé: | Troubles cognitifs dégénératifs et vasculaires - U 1171 (TCDV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille) |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Mechanical Thrombolysis [SDV]Life Sciences [q-bio] medicine.medical_treatment Population Health Services Accessibility Brain Ischemia Hospitals Private 03 medical and health sciences 0302 clinical medicine Fibrinolytic Agents Modified Rankin Scale Internal medicine medicine Humans 030212 general & internal medicine education Stroke Aged Thrombectomy Aged 80 and over education.field_of_study Hospitals Public business.industry Cerebral Infarction Thrombolysis Middle Aged medicine.disease Confidence interval 3. Good health Mechanical thrombectomy Population based study Treatment Outcome Neurology Female Cerebral ischaemia France Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Revue Neurologique Revue Neurologique, 2019, 175, pp.519-527. ⟨10.1016/j.neurol.2018.12.010⟩ Revue Neurologique, Elsevier Masson, 2019, 175, pp.519-527. ⟨10.1016/j.neurol.2018.12.010⟩ |
| ISSN: | 0035-3787 |
| DOI: | 10.1016/j.neurol.2018.12.010 |
| Popis: | Background and purpose Hospitals admitting acute strokes should offer access to mechanical thrombectomy (MT), but local organisations are still based on facilities available before MT was proven effective. MT rates and outcomes at population levels are needed to adapt organisations. We evaluated rates of MT and outcomes in inhabitants from the North-of-France (NoF) area. Method We prospectively evaluated rates of MT and outcomes of patients at 3 months, good outcomes being defined as a modified Rankin scale (mRS) 0 to 2 or like the pre-stroke mRS. Results During the study period (2016–2017), 666 patients underwent MT (454, 68.1% associated with intravenous thrombolysis [IVT]). Besides, 1595 other patients received IVT alone. The rate of MT was 81 (95% confidence interval [CI] 72–90) per million inhabitants-year, ranging from 36 to 108 between districts. The rate of IVT was 249 (95% CI 234–264) per million inhabitants-year, ranging from 155 to 268. After 3 months, 279 (41.9%) patients who underwent MT had good outcomes, and 167 (25.1%) had died. Patients living outside the district of Lille where the only MT centre is, were less likely to have good outcomes at 3 months, after adjustment on age, sex, baseline severity, and delay. Conclusion The rate of MT is one of the highest reported up to now, even in low-rate districts, but outcomes were significantly worse in patients living outside the district of Lille, and this is not only explained by the delay. |
| Databáze: | OpenAIRE |
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