@article {Balucanie1038作者= {Balucani, Clotilde莱文,Steven r . Sanossian,合作伙伴和斯达克曼,西德尼·里贝斯金和大卫和Gornbein,杰弗里·a·Shkirkova,克里斯蒂娜和Stratton,撒母耳和Eckstein,马克和汉密尔顿,斯科特和Conwit, Robin Sharma, Latisha k和储蓄者,Jeffrey L。}、标题={神经改善急性脑缺血},体积={100}={10},页面= {e1038——e1047} = {2023}, doi = {10.1212 / WNL。出版商0000000000201656}= {Wolters Kluwer健康,公司代表美国神经病学学会},文摘={调查背景和目标的快速神经功能改善(RNI)在急性脑缺血患者(ACI)关注RNI首页发生后医院的到来。然而,随着中风路由决策和干预越来越迁移到送往医院之前的设置,需要描述的频率、大小,预测,ACI患者的临床结果ultra-early RNI (U-RNI)患者的院前和postarrival早期。方法分析了前瞻性收集的数据送往医院之前的字段的中风治疗管理{\ textendash}镁(FAST-MAG)随机临床试验。任何U-RNI是由2个或更多的点定义为改善洛杉矶汽车规模(打)得分之间的院前和后早期{\ textendash}急诊科(ED)到达考试和归类为中等(2 {\ textendash} 3点)或戏剧性的改善(4 {\ textendash} 5点)。结果评价包括优秀的恢复(改良Rankin规模(夫人)得分0 {\ textendash} 1)和死亡的90天。结果在1245例ACI患者,平均年龄为70.9岁(标准差13.2);45 \ %是女性;院前逃亡中位数为4(四分位范围(差)3 {\ textendash} 5);最后熟悉ED-LAMS中位数时间为59分钟(IQR 46 {\ textendash} 80分钟),和中值送往医院之前的脱逃ED-LAMS时间是33分钟(IQR 28 {\ textendash} 39分钟)。总的来说,任何U-RNI发生在31 \ %,温和U-RNI 23 \ %,大幅U-RNI 8 \ %。任何U-RNI与改善的结果,包括优秀的复苏(夫人评分0 {\ textendash} 1) 65.1 90天\ %(246/378)和35.4 \ % (302/852),p < 0.0001; \ decreased mortality by 90 days 3.7\% (14/378) vs 16.4\% (140/852), p \< 0.0001; decreased symptomatic intracranial hemorrhage 1.6\% (6/384) vs 4.6\% (40/861), p = 0.0112; and increased likelihood of being discharged home 56.8\% (218/384) vs 30.2\% (260/861), p \< 0.0001.Discussion U-RNI occurs in nearly 1 in 3 ambulance-transported patients with ACI and is associated with excellent recovery and decreased mortality at 90 days. Accounting for U-RNI may be useful for routing decisions and future prehospital interventions.Trial Registration Information clinicaltrials.gov. Unique identifier: NCT00059332.ACI=acute cerebral ischemia; ASPECTS=Alberta Stroke Program Early CT Score; ED=emergency department; IV t-PA=IV tissue plasminogen activator; LAMS=Los Angeles Motor Scale; LKW=last known well; mRS=modified Rankin Scale; NIHSS=NIH Stroke Scale; ROC=receiver operator characteristic curve; SICH=symptomatic intracranial hemorrhage; U-RNI=ultra-early rapid neurologic improvement}, issn = {0028-3878}, URL = {//www.ez-admanager.com/content/100/10/e1038}, eprint = {//www.ez-admanager.com/content/100/10/e1038.full.pdf}, journal = {Neurology} }