基于Logistic回归及ROC曲线研究卒中患者120急救入院的影响因素

Study of influencing factors of 120 emergency admission in patients with stroke based on Logistic regression and ROC curve

目的探讨卒中患者选择120急救入院的影响因素,为更加精准的溶栓临床药学干预提供证据。方法选取2019年12月至2022年12月在深圳市龙华区人民医院神经内科住院的患者为研究对象,将93例完成完整调查的120急救入院患者纳入病例组,将同期255例完成完整调查的非120急救入院患者纳入对照组。通过临床药师结构式访谈获取患者的人口学资料、溶栓态度、疾病情况、FAST卒中症状知晓情况、卒中分型知晓情况及药物种类知晓情况。分析卒中患者120急救入院的影响因素。结果两组的独居、婚况、听说过溶栓、愿意溶栓、担心何种溶栓风险、知晓3 h溶栓时间窗、既往血管病史、言语含糊或听不懂别人说话、卒中分型知晓度及药物种类知晓度比较,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,愿意溶栓、听说过溶栓、担心何种溶栓风险、知晓3 h溶栓时间窗是卒中患者120急救入院的影响因素(P<0.05)。结论卒中患者的溶栓知识与积极信念是其选择120急救入院的重要影响因素,这为更加精准的临床药学干预服务提供了依据。

Objective To explore the influencing factors of the selection of 120 emergency admission for stroke patients,and to provide evidences for more accurate clinical pharmaceutical intervention of thrombolysis.Methods The patients who were hospitalized in the neurological department of the People's Hospital of Longhua,Shenzhen from December 2019 to December 2022 were selected as the research objects,93 patients who completed the complete investigation of 120 emergency admission were included in case group,and 255 patients who completed the complete investigation of non-120 emergency admission during the same period were included in control group.Through structured interviews with clinical pharmacists,the patients'demographic data,thrombolysis attitude,disease status,awareness of FAST stroke symptoms,awareness of stroke classification and awareness of drug types were obtained.The influencing factors of 120 emergency admission in stroke patients were analyzed.Results There were statistically significant differences between the two groups in living alone,marital status,having heard of thrombolysis,willingness to thrombolysis,worrying about the risk of thrombolysis,knowing the time window of 3 h thrombolysis,previous vascular history,vague or incomprehensible speech,awareness of stroke classification and awareness of drug types(P<0.05).Multivariate Logistic regression analysis results showed that willingness to thrombolysis,having heard of thrombolysis,worrying about the risk of thrombolysis and knowing the time window of 3 h thrombolysis were the influencing factors of 120 emergency admission of stroke patients(P<0.05).Conclusion Thrombolytic knowledge and positive beliefs of stroke patients are important influencing factors for their choice of 120 emergency admission,which provides a basis for more accurate clinical pharmacy intervention services.