RT期刊文章SR电子T1神经改善急性脑缺血摩根富林明神经病学神经学乔FD Lippincott Williams &威尔金斯SP e1038 OP e1047 10.1212 /首页 WNL。100签证官0000000000201656是10 A1 Clotilde Balucani A1史蒂文·r·莱文A1合作伙伴Sanossian A1西德尼·斯达克曼A1大卫Liebeskind A1杰弗里·a·Gornbein A1克里斯蒂娜Shkirkova A1塞缪尔·斯垂顿A1 Marc Eckstein A1斯科特·汉密尔顿A1罗宾Conwit A1 Latisha k Sharma A1 Jeffrey l .节省年2023 UL //www.ez-admanager.com/content/100/10/e1038.abstract AB调查背景和目标的快速神经功能改善(RNI)在急性脑缺血首页患者(ACI)关注RNI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。送往医院之前的字段的方法分析了前瞻性收集的数据管理中风Therapy-Magnesium (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)送往医院之前的事故后初部门之间的分数(ED)到达考试分为中度(2 - 3点)或戏剧性的改善(4 - 5点)。结果评价包括优秀的恢复(改良Rankin规模(夫人)评分0 - 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 - 5个);最后熟悉ED-LAMS中位数时间为59分钟(IQR 46 - 80分钟),和中值送往医院之前的脱逃ED-LAMS时间是33分钟(差28-39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(夫人得分0 - 1)在90天65.1%(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