Stroke:急诊脑静脉血栓形成的误诊分析!

2018-04-25 xing.T MedSci原创

由此可见,在一个大型的、异质的多状态队列中,30例患者中有1例可能出现CVT误诊,但与不良临床结局无关。

急诊脑静脉血栓形成(CVT)误诊率以及与误诊相关的结局尚未明确。近日,卒中领域权威杂志Stroke上发表了一篇研究文章,研究人员利用行政数据,确定了纽约、加利福尼亚和佛罗里达州医院中2005年至2013年期间诊治的成年CVT患者。

该研究的主要结局为可能的CVT误诊。此外,研究人员使用Logistic回归比较了有无CVT误诊患者的临床转归率,并在2个三级护理中心进行了验证性研究。

该研究共确定了5966例CVT患者,其中216例(3.6%;95%可信区间[CI]为1.1%~4.1%)有可能的CVT误诊。在调整人口统计学、CVT的危险因素和Elixhauser合并症指数之后,可能的CVT误诊与住院死亡率(比值比为0.14、95%CI为0.02~1.05)、脑出血(比值比为0.97、95%CI为0.57~1.65)或不良出院结局无关(比值比为0.90;95%CI为0.61~1.32);CVT误诊患者的住院时间较长(比值比为1.62;95% CI为1.04~2.50)。在验证性队列中,134例CVT患者中有8例发生CVT误诊(6%;95%CI为2.6%~11.4%)。

由此可见,在一个大型的、异质的多状态队列中,30例患者中有1例可能出现CVT误诊,但与不良临床结局无关。

原始出处:


Ava L. Liberman,et al. Misdiagnosis of Cerebral Vein Thrombosis in the Emergency Department.Stroke. 2018. https://doi.org/10.1161/STROKEAHA.118.021058

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    2018-08-04 xue8602
  2. [GetPortalCommentsPageByObjectIdResponse(id=1955360, encodeId=13a919553600b, content=<a href='/topic/show?id=0aeb991e44c' target=_blank style='color:#2F92EE;'>#静脉血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99174, encryptionId=0aeb991e44c, topicName=静脉血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Sat Aug 04 17:17:00 CST 2018, time=2018-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1697680, encodeId=a684169e680c8, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Tue Jun 12 10:17:00 CST 2018, time=2018-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483270, encodeId=0bfe14832e0d2, content=<a href='/topic/show?id=c82e991e71b' target=_blank style='color:#2F92EE;'>#静脉血栓形成#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99177, encryptionId=c82e991e71b, topicName=静脉血栓形成)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1d387907505, createdName=ms5187542471278033, createdTime=Fri Apr 27 09:17:00 CST 2018, time=2018-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309206, encodeId=b1563092062e, content=好文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a62240667, createdName=张新亮1853311252142e2fm, createdTime=Wed Apr 25 19:05:07 CST 2018, time=2018-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309199, encodeId=fa0a3091990b, content=不错.学习了.做笔记了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Apr 25 18:44:27 CST 2018, time=2018-04-25, status=1, ipAttribution=)]
    2018-06-12 fusion
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    2018-04-25 张新亮1853311252142e2fm

    好文章.学习了

    0

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    2018-04-25 虈亣靌

    不错.学习了.做笔记了.谢谢分享!

    0

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