这份卒中后机械取栓治疗共识声明的原始版本于2014年11月16—18日在斯德哥尔摩召开的欧洲卒中组织（European Stroke Organisation, ESO）-卡罗林斯卡卒中更新会议期间得到批准。根据会议安排，在2015年利用新的临床试验数据对该声明进...这份卒中后机械取栓治疗共识声明的原始版本于2014年11月16—18日在斯德哥尔摩召开的欧洲卒中组织（European Stroke Organisation, ESO）-卡罗林斯卡卒中更新会议期间得到批准。根据会议安排，在2015年利用新的临床试验数据对该声明进行了更新。2015年2月，在瑞士伯尔尼召开的ESO冬季培训会期间组织了面对面会议对共识声明进行修订，然后通过电子邮件交换意见，最终版本得到各学会的认可。推荐意见与原始版本一致，证据等级更新到2015年2月20日为止，在2015年5月15日获得确认。ESO-卡罗林斯卡卒中更新会议的目的在于总结卒中治疗研究的最新进展并探讨如何将这些最新研究结果应用于临床实践。共识会议选择了一些议题进行讨论，与会者草拟一份共识声明并进行讨论。该声明接受了ESO指南委员会的指导。这份共识声明包括对急性卒中后机械取栓治疗的推荐意见，得到欧洲卒中组织ESO、欧洲神经微创治疗学会（European Society of Minimally Invasive Neurological Therapy, ESMINT）、欧洲神经放射学学会（European Society of Neuroradiology, ESNR）和欧洲神经病学学会（European Academy of Neurology, EAN）的支持。展开更多
Background and purpose Triage tools to identify candidates for thrombectomy are of utmost importance in acute stroke.No prognostic tool has yet gained any widespread use.We compared the predictive value of various mod...Background and purpose Triage tools to identify candidates for thrombectomy are of utmost importance in acute stroke.No prognostic tool has yet gained any widespread use.We compared the predictive value of various models based on National Institutes of Health Stroke Scale(NIHSS)subitems,ranging from simple to more complex models,for predicting large artery occlusion(LAO)in anterior circulation stroke.Methods Patients registered in the SITS international Stroke Register with available NIHSS and radiological arterial occlusion data were analysed.We compared 2042 patients harbouring an LAO with 2881 patients having no/distal occlusions.Using binary logistic regression,we developed models ranging from simple 1 NIHSS-subitem to full NIHSS-subitems models.Sensitivities and specificities of the models for predicting LAO were examined.results The model with highest predictive value included all NIHSS subitems for predicting LAO(area under the curve(AUC)0.77),yielding a sensitivity and specificity of 69%and 76%,respectively.The second most predictive model(AUC 0.76)included 4-NIHSS-subitems(level of consciousness commands,gaze,facial and arm motor function)yielding a sensitivity and specificity of 67%and 75%,respectively.The simplest model included only deficits in arm motor-function(AUC 0.72)for predicting LAO,yielding a sensitivity and specificity of 67%and 72%,respectively.Conclusions Although increasingly more complex models yield a higher discriminative performance for predicting LAO,differences between models are not large.Assessing grade of arm dysfunction along with an established stroke-diagnosis model may serve as a surrogate measure of arterial occlusion-status,thereby assisting in triage decisions.展开更多
文摘这份卒中后机械取栓治疗共识声明的原始版本于2014年11月16—18日在斯德哥尔摩召开的欧洲卒中组织（European Stroke Organisation, ESO）-卡罗林斯卡卒中更新会议期间得到批准。根据会议安排，在2015年利用新的临床试验数据对该声明进行了更新。2015年2月，在瑞士伯尔尼召开的ESO冬季培训会期间组织了面对面会议对共识声明进行修订，然后通过电子邮件交换意见，最终版本得到各学会的认可。推荐意见与原始版本一致，证据等级更新到2015年2月20日为止，在2015年5月15日获得确认。ESO-卡罗林斯卡卒中更新会议的目的在于总结卒中治疗研究的最新进展并探讨如何将这些最新研究结果应用于临床实践。共识会议选择了一些议题进行讨论，与会者草拟一份共识声明并进行讨论。该声明接受了ESO指南委员会的指导。这份共识声明包括对急性卒中后机械取栓治疗的推荐意见，得到欧洲卒中组织ESO、欧洲神经微创治疗学会（European Society of Minimally Invasive Neurological Therapy, ESMINT）、欧洲神经放射学学会（European Society of Neuroradiology, ESNR）和欧洲神经病学学会（European Academy of Neurology, EAN）的支持。
基金SITS is financed directly and indirectly by grants from Karolinska Institutet,Stockholm County Council,the Swedish Heart-Lung Foundation,the Swedish Order of St.John,Friends of Karolinska Institutet and private donors as well as from an unrestricted sponsorship from Boehringer-Ingelheim.SITS has previously received grants from the European Union Framework 7,the European Union Public Health Authority and Ferrer Internacional+3 种基金SITS is currently conducting studies supported by Boehringer-Ingelheim and EVER Pharma as well as in collaboration with Karolinska Institutet,supported by Stryker,Covidien and Phenox.RM has been supported by the project no.LQ1605 from the National Program of Sustainability II(MEYS CR)the project FNUSA-ICRC no.CZ.1.05/1.1.00/02.0123(OP VaVpI).JFS is participant in the CharitéClinical Scientist Program funded by the CharitéUniversitätsmedizin Berlin and the Berlin Institute of Health.
文摘Background and purpose Triage tools to identify candidates for thrombectomy are of utmost importance in acute stroke.No prognostic tool has yet gained any widespread use.We compared the predictive value of various models based on National Institutes of Health Stroke Scale(NIHSS)subitems,ranging from simple to more complex models,for predicting large artery occlusion(LAO)in anterior circulation stroke.Methods Patients registered in the SITS international Stroke Register with available NIHSS and radiological arterial occlusion data were analysed.We compared 2042 patients harbouring an LAO with 2881 patients having no/distal occlusions.Using binary logistic regression,we developed models ranging from simple 1 NIHSS-subitem to full NIHSS-subitems models.Sensitivities and specificities of the models for predicting LAO were examined.results The model with highest predictive value included all NIHSS subitems for predicting LAO(area under the curve(AUC)0.77),yielding a sensitivity and specificity of 69%and 76%,respectively.The second most predictive model(AUC 0.76)included 4-NIHSS-subitems(level of consciousness commands,gaze,facial and arm motor function)yielding a sensitivity and specificity of 67%and 75%,respectively.The simplest model included only deficits in arm motor-function(AUC 0.72)for predicting LAO,yielding a sensitivity and specificity of 67%and 72%,respectively.Conclusions Although increasingly more complex models yield a higher discriminative performance for predicting LAO,differences between models are not large.Assessing grade of arm dysfunction along with an established stroke-diagnosis model may serve as a surrogate measure of arterial occlusion-status,thereby assisting in triage decisions.
