Analysis of therapeutic efficacy of simplified diagnosis and treatment for outpatients with acute mild ischemic stroke in designated hospitals during the COVID-19 pandemic

doi:10.16138/j.1673-6087.2022.05.007

Abstract

Abstract:

Objective To summarize the clinical characteristics of outpatients with acute mild stroke and analyze the therapeutic efficacy of simplified diagnosis and treatment for the patients during the period of epidemic prevention and control. Methods Eighty-seven outpatients with acute mild stroke in Beijing Men Tou Gou District Hospital from January 27 to September 27 in 2020 were enrolled as observation group (n=87). Simplified diagnosis and treatment were performed on the observation group, and the stroke-related neurologic deficits were evaluated with 7-day National Institutes of Health Stroke Scale (NIHSS) score and 90-day modified Rankin scale (mRS) score. Seventy-five patients with acute mild ischemic stroke admitted to were enrolled as control group (n=75) during the same period. The clinical characteristics, biochemistry index, 7-day NIHSS score and 90-day mRS score were analyzed and compared between control group and observation group. Results Univariate analysis showed the time from appearing stroke symptom to receiving treatment in the observation group [3（2,4） day] was significantly longer than that in the control group[ 1（0.3,3） day]（Z=-4.234, P=0.000), while the infusion time of therapeutic medicine and treatment cost in observation group were significantly lower than that in control group[6（5,7） d vs 10（7,12） d, P=0.000; (5 666.05±2 343.78) yuan vs (12 590.11±3 815.52) yuan, P=0.000 ]. The two groups had no significant differences in 0-day NIHSS score, 7-day NIHSS score and 90-day mRS score （90 d mRS≤2）[2(1,3) vs 2(1,3);1(0,1) vs 1(0,3); 87.35% vs 84.00%, P>0.05]. Conclusions The patients with acute mild stroke were not necessary to be hospitalized and could be managed with simplified diagnosis and treatment in outpatient department during the period of pandemic or non-pandemic.

Key words: COVID-19, Epidemic, Mild stroke, Outpatient, Simplified diagnosis and treatment

CLC Number:

R733.71

GAO Caihong. Analysis of therapeutic efficacy of simplified diagnosis and treatment for outpatients with acute mild ischemic stroke in designated hospitals during the COVID-19 pandemic[J]. Journal of Internal Medicine Concepts & Practice, 2022, 17(05): 385-389.

Figures/Tables 3

References 18

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项目	对照组（75例）	观察组（87例）	t/χ²	P
年龄（岁）	63.71±11.38	63.02±13.01	-0.353	0.724
男性[n（%）]	57(76.0)	62(71.3)	0.463	0.496
吸烟[n（%）]	38(50.7)	50(57.5)	0.752	0.386
高血压[n（%）]	60(80.0)	71(81.6)	0.067	0.795
糖尿病[n（%）]	32(42.7)	30(34.5)	1.142	0.285
房颤[n（%）]	4(5.3)	2(2.3)	1.040	0.308
中重度颅内外动脉狭窄[n（%）]	38(50.6)	33(37.9)	2.654	0.103
LDL-C (mmol/L)	3.66±2.84	3.34±0.94	-0.977	0.330
Hcy (μmol/L)	16.43±7.66	15.21±7.11	-1.049	0.296
梗死类型[n（%）] 单纯后循环[n（%）]	31(41.3)	28(32.2)	1.456	0.228
LAA	45（60.0）	54(62.1)	0.073	0.788
SAO	23(30.7)	29(33.3)	0.131	0.717
CE	2(2.7)	1(1.2)	0.510	0.475
OE+UE	5(6.7)	3（3.5）	0.889	0.346

项目	对照组（75例）	观察组（87例）	t/Z	P
就诊时NIHSS评分（分）	2（1,3）	2（1,3）	-1.022	0.307
发病时间（d）	1（0.3,3）	3（2,4）	-4.234	0.000
输液时长（d）	10（7,12）	6（5,7）	-8.167	0.000
治疗费用（元）	12 590.11±3 815.52	5 666.05±2 343.78	-14.12	0.000

项目	对照组（75例）	观察组（87例）	Z/χ²	P
7 dNIHSS评分（分）	1（0,3）	1（0,1）	-1.755	0.079
90 dmRS≤2分	63（84.00）	76（87.35）	0.372	0.542