Kev sib piv ntawm Prehospital Scales rau Predicting Loj Anterior Vessel Occlusion nyob rau hauv Ambulance Teem

By Cristiano Antonino Xeem tshiab Nov 21, 2021

Prehospital scales thiab lawv cov txiaj ntsig hauv tsheb thauj neeg mob, txoj kev tshawb fawb luam tawm hauv Jama pib nrog cov lus nug no: dab tsi yog qhov ua tau zoo thiab qhov ua tau zoo ntawm kev kwv yees ntsuas rau cov hlab ntsha loj hauv lub cev thaum siv tau sab nraud thiab piv rau lub taub hau rau lub taub hau hauv qhov chaw kho mob xwm txheej ceev?

Hauv txoj kev tshawb no ntawm cov neeg mob uas tau txais tus lej mob stroke, 7 qhov ntsuas kev ntsuas ua ntej hauv tsev kho mob tau txheeb xyuas

Hauv qhov kev tshawb fawb no ntawm xyoo 2007 cov neeg mob uas tau txais cov lej mob stroke, 7 qhov kev kwv yees ntsuas tau pom cov qhab nia raug zoo, qhov tshwj xeeb siab, thiab tsis tshua muaj rhiab heev, statistically nyiam Los Angeles Motor Scale thiab Rapid Arterial Occlusion Evaluation scale.

Cov kev ua tau zoo tau pom zoo rau Prehospital Acute Stroke Severity scale.

Cov txiaj ntsig tam sim no qhia tias qhov sib txawv me me tab sis muaj txiaj ntsig tseem ceeb hauv qhov tseeb tshwm sim ua rau muaj txiaj ntsig zoo hauv cov neeg coob dua rau kev txo qis kev kho mob qeeb, nrog cov txiaj ntsig kho mob tau zoo dua qub, thiab qhov ua tau zoo yuav tsum tau txiav txim siab ua ntej siv qhov ntsuas.

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Qhov tseem ceeb ntawm kev ntsuas ua ntej hauv tsev kho mob hauv tsheb thauj neeg mob

Kev ua tau zoo ntawm endovascular thrombectomy (EVT) rau cov tsos mob loj anterior hlab ntsha occlusion (sLAVO) sharply txo nrog lub sij hawm.

Vim tias EVT raug txwv rau cov chaw kho mob stroke, prehospital triage ntawm cov neeg mob uas mob stroke codes rau sLAVO yog qhov tseem ceeb, thiab txawm hais tias ntau qhov kev kwv yees tau siv los lawm, kev siv tau sab nraud, kev sib piv ntawm taub hau, thiab cov ntaub ntawv ua tau tsis muaj.

Lub Hom Phiaj: Txhawm rau ua qhov kev lees paub sab nraud thiab kev sib piv ntawm lub taub hau ntawm 7 sLAVO twv twv ntsuas hauv qhov chaw kho mob xwm txheej ceev (EMS) thiab ntsuas ntsuas qhov ua tau los ntawm EMS cov kws kho mob.

Txoj kev tshawb fawb yav tom ntej no tau ua thaum Lub Xya Hli 2018 thiab Lub Kaum Hli 2019 hauv lub nroog loj hauv Netherlands nrog cov pej xeem ntawm kwv yees li 2 lab tus tib neeg thiab suav nrog 2 EMSs, 3 qhov chaw kho mob stroke, thiab 4 lub chaw mob stroke.

Cov neeg koom nrog yog cov neeg mob sib law liag hnub nyoog 18 xyoo lossis tshaj saud rau tus uas EMS-pib tus kab mob stroke raug qhib.

Ntawm 2812 tus lej mob stroke, 805 (28.6%) raug cais tawm, vim tsis muaj daim ntawv thov siv lossis tsis muaj cov ntaub ntawv kho mob, tawm hauv 2007 cov neeg mob suav nrog hauv kev tshuaj ntsuam.

TXHEEJ TXHEEM KHO MOB RAU COV NTAUB NTAWV THIAB THAWJ KEV PAB CUAM THAWJ: DMC DINAS KEV KHO MOB NKAUS LOS NTAWM KEV KAWM

Cov ntsuas ntsuas prehospital ntsuas ntsuas

Cov ntawv thov nrog cov kev soj ntsuam soj ntsuam tau sau los ntawm EMS cov kws kho mob rau txhua tus mob stroke code ua kom rov tsim kho ntawm 7 qhov kev kwv yees hauv qab no: Los Angeles Motor Scale (LAMS); Kev ntsuam xyuas sai sai ntawm Arterial Occlusion (RACE); Cincinnati Stroke Triage Assessment Tool; Prehospital Acute Stroke Severity (PASS); ntsia-ntsej muag-arm-speech-time; Field Assessment Stroke Triage rau Emergency Destination; thiab ntsia, lub ntsej muag asymmetry, theem ntawm kev nco qab, extinction / inattention.

Kev npaj thawj zaug thiab cov txiaj ntsig thib ob yog sLAVO thiab qhov ua tau zoo (piv txwv li, qhov feem pua ntawm cov kab mob mob stroke uas qhov ntsuas prehospital tuaj yeem rov tsim dua).

Kev ntsuas kev ua tau zoo suav nrog qhov tseeb, qhov nkag siab, qhov tshwj xeeb, Youden Performance index, thiab cov txiaj ntsig kwv yees.

Ntawm 2007 cov neeg mob uas tau txais tus lej mob stroke (txhais tau tias [SD] hnub nyoog, 71.1 [14.9] xyoo; 1021 [50.9%] txiv neej), 158 (7.9%) muaj sLAVO.

Qhov tseeb ntawm cov nplais yog li ntawm 0.79 txog 0.89, nrog LAMS thiab RACE cov nplais tau txais cov qhab nia siab tshaj.

rhiab heev ntawm cov teev muaj li ntawm 38% mus rau 62%, thiab tshwj xeeb los ntawm 80% mus rau 93%.

Scale feasibility rates ranges ntawm 78% mus rau 88%, nrog tus nqi siab tshaj plaws rau PASS nplai.

Txoj kev tshawb no pom tias tag nrho 7 qhov kev twv twv ntsuas muaj qhov raug zoo, qhov tshwj xeeb siab, thiab tsis tshua muaj siab, nrog LAMS thiab RACE yog qhov qhab nia siab tshaj plaws.

Qhov kev ua tau zoo nyob nruab nrab ntawm 78% thiab 88% thiab yuav tsum tau coj mus rau hauv tus account ua ntej siv qhov ntsuas.

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