当前位置: X-MOL 学术Ann. Emerg. Med. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Covert Brain Infarction in Emergency Department Patients: Prevalence, Clinical Correlates, and Treatment Opportunities
Annals of Emergency Medicine ( IF 6.2 ) Pub Date : 2021-12-23 , DOI: 10.1016/j.annemergmed.2021.10.011
Jessica R Balderston 1 , Christopher K Brown 1 , V Ramana Feeser 1 , Zachary M Gertz 2
Affiliation  

Study objective

Covert brain infarctions are focal lesions detected on brain imaging consistent with ischemia in the absence of a history of overt stroke or neurologic dysfunction. Covert brain infarctions are associated with an increased risk of future stroke. We evaluated the prevalence of covert brain infarctions in patients undergoing computed tomography (CT) in the emergency department (ED), as well as clinician response to the findings.

Methods

Patients aged more than 50 years who underwent CT of the head and were seen and discharged from our ED from January to September 2018 were identified. Patients with a history of stroke, or prior brain imaging with ischemia, were excluded. Patient data and clinician response (patient notification, neurology referral, and risk factor modification) were collected.

Results

We included 832 patients, with an average age of 62 years, and 50% of the patients were women. Covert brain infarctions were present in 11% of patients (n=95). Only 9% of patients with covert brain infarctions were clearly made aware of the finding. Of the patients with covert brain infarctions, 27% were already on aspirin and 28% on a statin. Aspirin was added for 2 patients, and statin medication was not started on any patient. The blood pressure medication was added or adjusted for 2 patients with covert brain infarctions. The neurology department was consulted for 9% of the patients with covert brain infarctions.

Conclusion

The prevalence of covert brain infarctions in patients older than 50 years presenting to the ED who underwent CT of the head and were subsequently discharged from the ED was 11%. Only 9% of these patients were made aware of the finding, with minimal intervention for stroke prevention at the time of their visit. Interventions targeting this population should be considered.



中文翻译:

急诊科患者隐匿性脑梗死:患病率、临床相关性和治疗机会

学习目标

隐匿性脑梗死是在没有明显中风或神经功能障碍病史的情况下,在脑成像中检测到与缺血一致的局灶性病变。隐蔽性脑梗塞与未来中风的风险增加有关。我们评估了急诊科 (ED) 接受计算机断层扫描 (CT) 患者隐匿性脑梗死的患病率,以及临床医生对这些发现的反应。

方法

年龄超过 50 岁的患者接受了头部 CT,并在 2018 年 1 月至 2018 年 9 月期间从我们的 ED 就诊并出院。有中风病史或先前有缺血性脑成像的患者被排除在外。收集患者数据和临床医生反应(患者通知、神经科转诊和风险因素修正)。

结果

我们纳入了 832 名患者,平均年龄为 62 岁,其中 50% 的患者为女性。11% 的患者(n=95)存在隐匿性脑梗塞。只有 9% 的隐匿性脑梗死患者清楚地意识到了这一发现。在隐匿性脑梗死患者中,27% 已服用阿司匹林,28% 已服用他汀类药物。2 例患者加用阿司匹林,未开始任何患者的他汀类药物治疗。2 例隐匿性脑梗死患者加用或调整血压药物。9% 的隐匿性脑梗死患者曾向神经内科咨询。

结论

50 岁以上就诊于 ED 并接受头部 CT 并随后从 ED 出院的患者隐匿性脑梗塞的发生率为 11%。这些患者中只有 9% 知道这一发现,在就诊时对卒中预防的干预很少。应考虑针对这一人群的干预措施。

更新日期:2021-12-23
down
wechat
bug