Left atrial appendage occluder implantation for stroke prevention in elderly patients with atrial fibrillation： acute and long-term results

Atrial fibrillation （AF） is the most common cardiac ar-rhythmia in clinical practice with an increasing incidenceand prevalence. With ageing, the risk of thromboembolicand hemorrhagic events increases dramatically. As it hasbeen reported previously, 3-year survival rate among pa-tients with AF over 75 years of age after stroke is less than50%, and almost 90% of those patients will remain dis-abled.

Efficacy and Safety of the WATCHMAN Left Atrial Appendage System for Stroke Prevention in Chinese Patients with Nonvalvular Atrial Fibrillation： A Single-center, Prospective, Observational Study

Background： In patients with nonvalvular atrial fibrillation （NVAF）, embolic stroke is thought to be associated with left atrial appendage （LAA） thrombi. The WATCHMAN LAA Occlusion Device has been shown to be noninferior to conventional oral anticoagulation with warfarin for stroke prevention in patients with NVAF. This study aimed to evaluate the procedural feasibility, safety and 12-month outcomes of the WATCHMAN LAA Occlusion Device in NVAF patients with high risk for stroke in China. Methods： The clinical data of 106 NVAF patients, who were consecutively underwent LAA closure with the WATCHMAN Device between April 2014 and May 2015, were collected. Patients were followed up at 1,3, 6, and 12 months after discharge. A transesophageal echocardiograph was performed at 45 days after implantation and repeated in case of an unexpected event during the follow-up period. Results： This study included 106 NVAF patients with a mean age of 64.2 ± 8.6 years （ranging from 50 to 88 years）, and the mean CHA,DS,-VASc score of all patients was 3.6 ± 1.6 （ranging from 2 to 9）. Among those 106 NVAF patients, 100 （94.3%） patients were implanted with the device successfully. The procedural success rate was 94.3% （100/106）, and the occlusion rate was 100.0% （100/100）. There were one tamponade, one ischemic stroke, and eight minor pericardial effusions during hospitalization. During 12-month follow-up period, two patients developed a tbrombus layer on the device that resolved with additional anticoagulation： one with visible device-thrombus experienced transient ischemic stroke, and one had a hemorrhagic stroke. There were no deaths in this study. The overall survival rate was 100.0%, and nonmajor adverse event rate was 95.0% （95/100）. In this study, the expected annual rate ofischemic stroke risk in these patients according to the CHA2DS2-VASc score was 4.0%, while the observed ischemic stroke rate was 2.0% per year. Conclusions： LAA closure with the WATCHMAN Device was feasible, efficient, and safe for NVAF to prevent the accidence of stroke in Chinese patients. During the 12-month follow-up period, the observed ischemic stroke rate （2.0% per year） in our study was lower than the predicted annual stroke risk （4.0%） using the CHA2DS：-VASc score.

Assessing Cardiovascular Health Using Life＇s Simple 7 in a Chinese Population Undergoing Stroke Prevention

Background： The American Heart Association/American Stroke Association proposed a metric called Life＇s Simple 7 （LS7） to define cardiovascular health （CVH）. The presence of a large number of ideal components of CVH is associated with lower cardiovascular disease and all-cause mortality. We aimed to assess CVH using LS7 in a Chinese population undergoing primary and secondary stroke prevention. Methods： Patients with either ischemic stroke or cardiovascular risk factors were enrolled in the study from October 2010 to July 2013. LS7 components were scored as poor （0 points）, intermediate （1 point）, or ideal （2 points）. The overall LS7 score was categorized as inadequate （0-4）, average （5-9）, or optimal （10-14） CVH. The Chi-square test, Mann-Whitney U-test, and Kruskal-Wallis test were used. Results： In total, 706 patients were enrolled. （1） The distribution of the overall LS7 score （n = 255） indicated that 9.4%, 82.4%, and 8.2% of the patients had inadequate, average, and optimal CVH, respectively. The proportion of patients with optimal CVH undergoing secondary stroke prevention was lower than that for patients undergoing primary stroke prevention （3.8% vs. 12.8%, P = 0,005）. The vast laaajority of participants （76.1%） presented with 〈2 ideal health components. （2） The proportions of patients with poor, intermediate, and ideal status, respectively, lbr the following LS7 components were assessed： Total cholesterol （n = 275; 5.1%, 73.8%, and 21.1%）, blood pressure （11 = 351 ; 32.5%. 59.0%, and 8.5%）, blood glucose （n = 280; 9.3%, 39.6%, and 51.1%）, physical activity （n = 540; 90.7%, 8.7%, and 0.6%）, diet （n = 524; 0.2%. 92.4%, and 7.4%）, smoking （n = 619： 20.7%, 2.9%, and 76.4%）, and body mass index （n = 259; 6.6%, 35.5%, and 57.9%）. Conclusions： Few Chinese patients undergoing stroke prevention had optimal CVH （determined using LS7）. Additionally, fewer patients undergoing secondary prevention had optimal CVH than those undergoing primary prevention. In particular, physical activity and diet status in this population require improvement.

Public Awareness of Stroke Symptoms Can Save Lives

5月16日的Yahoo上刊登了此文,读后我非常兴奋。把它介绍给我的朋友和同事。他们觉得此文传递的信息十分重要,建议我将此文作为注释读物发给贵刊。Stroke,汉语称之为“中风”,在当今之美国,是第三大死因。许多患者本人对中风的病症了解甚少,许多bystanders对中风病人的发病状态和急救方式也知之不多,因此,原本可以得救的病人就白白错过了救治良机。在美国首都的NINDS(全国神经紊乱及中风协会)在今年五月开展了一场运动,运动的名称为:Know Stroke: Know the Signs,Act in Time(是否可译:认识中风:了解症状,及时采取救治行动)。此运动可以让患者掌握更多的治疗处置中风病的知识。同时,又能让bystanders懂得救治的正确方法。NINDS的负责人如此幽默地说:This is a bystander's chance to be a hero,because you really can save a life with the right information. 文章除了提供了加强自我保健,避免罹患中风之外,还告诉我们中风发作之前的症状。这些症状一共有五条。希望读者朋友细读勤记,说不准哪一天,这些从杂志上得来的知识派上了大用场,让你成了a hero!本文的文字不错,尤其值得玩味的一个词是needlessly(见倒数第二行),作为non native-speaker,似乎很难如此使用此副词。

Impact of Smoke-Free Legislation on Acute Myocardial Infarction and Subtypes of Stroke Incidence in Shenzhen,China,2012-2016:An Interrupted Time Series Analysis

Objective This study assesses the impact of smoke-free legislation on the incidence rate for acute myocardial infarction(AMI)and stroke in Shenzhen.Methods Data on ischemic(n=72,945)and hemorrhagic(n=18,659)stroke and AMI(n=17,431)incidence covering about 12 million people in Shenzhen from 2012 to 2016 were used.Immediate and gradual changes in incidence rates were analyzed using segmented Poisson regression.Results Following the smoke-free legislation,a 9%(95%CI:3%-15%)immediate reduction was observed in AMI incidence,especially in men(8%,95%CI:1%-14%)and in those aged 65 years and older(17%,95%CI:9%-25%).The gradual annual benefits were observed only in hemorrhagic and ischemic stroke incidence,with a 7%(95%CI:2%-11%)and 6%(95%CI:4%-8%)decrease per year,respectively.This health effect extended gradually to the 50-64 age group.In addition,neither the immediate nor gradual decrease in stroke and AMI incidence rates did not show statistical significance among the 35-49 age group(P>0.05).Conclusion Smoke-free legislation was enforced well in Shenzhen,which would generate good experiences for other cities to enact and enforce smoke-free laws.This study also provided more evidence of the health benefits of smoke-free laws on stroke and AMI.

Secondary prevention of ischaemic stroke

In spite of a documented reduction in incidence in highincome countries over the last decades, stroke is still a leading cause of death and disability worldwide. With the ageing of the population stroke-related economic burden is expected to increase, because of residual disability and its complications, such as cognitive impairment, high risk of falls and fractures, depression and epilepsy. Furthermore, because of the substantial rate of early and long-term vascular recurrences after the first event, secondary prevention after cerebral ischaemia is a crucial issue. This is even more important after minor stroke and transient ischaemic attack(TIA), in order to reduce the risk of potentially more severe and disabling events. To accomplish this aim, acute long-term medical and surgical treatments as well aslifestyle modifications are strongly recommended. However, apart from the well-established indications to thrombolysis, studies in acute phase after a first stroke or TIA are scarce and evidence is lacking. More trials are available for long-term secondary prevention with different classes of drugs, including antithrombotic medications for ischaemic events of arterial and cardiac origin, especially related to atrial fibrillation(antiplatelets and anticoagulants, respectively), lipid lowering agents(mainly statins), blood pressure lowering drugs, surgical and endovascular revascularization procedures.

Spectrum of neuropsychiatric symptoms in chronic post-stroke aphasia

BACKGROUND Neuropsychiatric symptoms(NPS)have been insufficiently examined in persons with aphasia(PWA)because most previous studies exclude participants with language and communication disorders.AIM To report a two-part study consisting of a literature review and an observational study on NPS in post-stroke aphasia.METHODS Study 1 reviewed articles obtained from PubMed,PsycINFO,Google Scholar and Cochrane databases after cross-referencing key words of post-stroke aphasia to NPS and disorders.Study 2 examined language deficits and activities of daily living in 20 PWA(median age:58,range:28-65 years;13 men)with the Western Aphasia Battery-Revised and the Barthel Index,respectively.Informants of these 20 PWA were proxy-evaluated with the Neuropsychiatric Inventory and domain-specific scales,including the Stroke Aphasia Depression Questionnaire-10 item version and the Starkstein Apathy Scale.In addition,an adapted version of the Hospital Anxiety and Depression Scale was directly administered to the PWA themselves.This observational study is based on the baseline assessment of an intervention clinical trial(EudraCT:2017-002858-36;ClinicalTrials.gov identifier:NCT04134416).RESULTS The literature review revealed a broad spectrum of NPS in PWA,including depression,anxiety,apathy,agitation/aggression,eating and sleep disorders,psychosis,and hypomania/mania.These findings alert to the need for improving assessment and treatment approaches of NPS taking into consideration their frequent occurrence in PWA.Study 2 showed that the 20 participants had mild-to-moderate aphasia severity and were functionally independent.A wide range of comorbid NPS was found in the post-stroke aphasic population(median number of NPS:5,range:1-8).The majority of PWA(75%)had depressive symptoms,followed by agitation/aggression(70%),irritability(70%),anxiety(65%)and appetite/eating symptoms(65%).Half of them also presented symptoms of apathy,whereas euphoria and psychotic symptoms were rare(5%).Domain-specific scales revealed that 45%of participants had apathy and 30%were diagnosed with depression and anxiety.CONCLUSION Concurrent NPS are frequent in the chronic period of post-stroke aphasia.Therefore,further research on reliable and valid assessment tools and treatment for this aphasic population is strongly warranted.

Risk Factors for Prevention Stroke (IS or TIA) Due to Cerebral Infarction in Young Adults: A Meta-Analytical Study

Ischemic strokes (IS), also referred to as cerebral ischemia or brain ischemia, is a significant cause to the brain cells damage or death. Approximately, 10% - 14% of ischemic strokes cases occurred in young adults. Hence, we conducted a meta-analysis to find the effective interventions to prevent the best strokes caused by cerebral infarction in young adults. The search was done in different databases, including Google scholar, PubMed, Embase, Medline, Cochrane Central Register of Controlled Trials, Cochrane Database, Scopus, and Web of Science from January 2016 to April 2020, and only English published articles were considered. Our analysis included studies that stratified the risk of ischemic stroke by CHA2DS2-VASc score for patients with nonvalvular atrial fibrillation. Further, random effects model was used to estimate the summary annual rate of IS. Pooled relative risks and odds ratios, with their 95% confidence intervals, were calculated, respectively. The analysis was conducted using STATA (version 12), pooled effect sizes were calculated using the random-effects model and heterogeneity was tested for using the I2 statistic. The analysis included 13 studies. The analysis shows that diabetes, high blood pressure, ischemic heart disease, atrial fibrillation, hypercholesterolemia, alcohol consumption and smoking are significant risk factors. In Caucasian and Chinese ischemic stroke patients, the risk factor associations associated with ischemic stroke subtypes are similar. Compared to all other ischemia subtypes, diabetes is more familiar with aortic stroke, atrial fibrillation, ischemic heart disease (with obstruction), hypertension and diabetes. Our research shows that atrial fibrillation, ischemic heart disease, and hypercholesterolemia are low in patients with ischemic stroke and the risk factors are higher. Further analysis of each patient’s data is required to enable confounders’ adjustments to confirm and expand these findings.

Prevention of ischemic stroke in diabetic patients

糖尿病可使发生缺血性卒中的风险增加2倍以上,并且合并缺血性卒中的糖尿病患者长期预后不良。目前所采取的强力降血糖治疗并未使糖尿病患者从缺血性卒中的一级和二级预防中获益。然而,有研究显示,具有针对性的缺血性卒中危险因素管理,特别是对不良生活方式、血糖、高血压、脂质代谢紊乱的干预,可预防糖尿病患者缺血性卒中的发生,并改善预后。在符合干预标准的糖尿病患者中,抗血栓治疗和颈动脉外科手术对缺血性卒中的一级和二级预防是必要的。本文拟对近年公布的糖尿病患者缺血性卒中一级和二级预防的相关证据进行概述,使临床医师了解该领域的研究现状与动态,从而更好地实施糖尿病患者的卒中预防措施。

Meta-Analysis of Aspirin for Primary Prevention of Stroke

Objective: This paper aims to evaluate the safety and efficacy of aspirin in primary stroke prevention by meta-analysis. Methods: By searching PubMed, Cochrane Library, Embase, MEDLINE, Web of Science, CNKI, China Biomedical Literature Database, VIP Database and Wanfang Database, we collected randomized controlled trials on aspirin for primary prevention of stroke. The retrieval time limit is from the establishment of the database to December 2021. Two researchers independently conducted literature search, screening, data extraction and quality evaluation, and Meta-analysis was performed using RevMan 5.3. Results: A total of 19 articles were included, including 220,636 subjects. Meta-analysis results show that long-term preventive use of aspirin can reduce the incidence of stroke [RR = 0.91, 95% CI (0.85, 0.98), P = 0.009], and reduce the incidence of ischemic stroke [RR = 0.84, 95% CI] (0.77, 0.91), P RR = 0.80, 95% CI (0.72, 0.88), P RR = 0.85, 95% CI (0.75, 0.97), P RR = 1.23, 95% CI (1.04, 1.46), P = 0.01] and gastrointestinal bleeding [RR = 1.62, 95% CI (1.35, 1.93), P RR = 0.97, 95% CI (0.93, 1.02), P = 0.20]. Conclusion: Long-term prophylactic use of aspirin can reduce the overall incidence of stroke, but there is also a risk of bleeding. The advantages and disadvantages of aspirin should be fully evaluated and strict screening should be carried out before medication, which can minimize adverse reactions and improve the safety and effectiveness of aspirin in the primary prevention of stroke.

Symptom experience and symptom burden of patients following first-ever stroke within 1 year： a cross-sectional study

Symptoms that are multidimensional and concurrent should be assessed from different dimensions and managed together. Few studies have evaluated concurrent and multidimensional symptoms in patients with stroke. Most studies of stroke focused on dysfunctions and complications. We hypothesize that patients with stroke have a heavy symptom burden within 1 year. This study aimed to describe multidimensional and concurrent symptoms within 1 year after stroke. This study recruited 230 patients with stroke from the Rehabilitation Department of Xuhui District Center Hospital of Shanghai and the Shanghai Sunshine Rehabilitation Center in China from March to September 2017. The patients＇ multidimensional symptom experience and symptom burden were analyzed using a self-made structured questionnaire and the influential factors for symptom burden were identified. The mean number of symptoms in patients with stroke was 11.7 ± 3.5. More than two thirds of the participants suffered from at least 10 co-occurring symptoms. Unilateral limb weakness had the highest prevalence and frequency. Participation restriction had the highest symptom dimensions of severity and distress. Lack of self-care ability（severity）, memory deterioration（frequency）, imbalance of body（distress）, moodiness（distress）, being unable to move limbs at will（distress）, shoulder pain（distress）, and slower response（frequency） were independent factors of the total symptom burden score. These findings can provide essential information for efficient symptom management of patients with stroke.

Leukoaraiosis is associated with clinical symptom severity,poor neurological function prognosis and stroke recurrence in mild intracerebral hemorrhage:a prospective multi-center cohort study

Leukoaraiosis(LA)results from ischemic injury in small cerebral vessels,which may be attributable to decreased vascular density,reduced cerebrovascular angiogenesis,decreased cerebral blood flow,or microcirculatory dysfunction in the brain.In this study,we enrolled 357 patients with mild intracerebral hemorrhage(ICH)from five hospitals in China and analyzed the relationships between LA and clinical symptom severity at admission,neurological function prognosis at 3 months,and 1-year stroke recurrence.Patients were divided into groups based on Fazekas scale scores:no LA(n=83),mild LA(n=64),moderate LA(n=98)and severe LA(n=112).More severe LA,larger hematoma volume,and higher blood glucose level at admission were associated with more severe neurological deficit.More severe LA,older age and larger hematoma volume were associated with worse neurological function prognosis at 3 months.In addition,moderate-to-severe LA,admission glucose and symptom-free cerebral infarction were associated with 1-year stroke recurrence.These findings suggest that LA severity may be a potential marker of individual ICH vulnerability,which can be characterized by poor tolerance to intracerebral attack or poor recovery ability after ICH.Evaluating LA severity in patients with mild ICH may help neurologists to optimize treatment protocols.This study was approved by the Ethics Committee of Ruijin Hospital Affiliated to Shanghai Jiao Tong University(approval No.12)on March 10,2011.

Associations between Lesion Locations and Stroke Recurrence in Survivors of First-ever Ischemic Stroke:A Prospective Cohort Study

Summary:Several studies have indicated that stroke survivors with multiple lesions or with larger lesion volumes have a higher risk of stroke recurrence.However,the relationship between lesion locations and stroke recurrence is unclear.We conducted a prospective cohort study of first-ever ischemic stroke survivors who were consecutively enrolled from January 2010 to December 2015.Stroke recurrence was assessed every 3 months after post-discharge via telephone interviews by trained interviewers.Lesion locations were obtained from hospital-based MRI or CT scans and classified using two classification systems that were based on cerebral hemisphere or vascular territory and brain anatomical structures.Flexible parametric survival models using the proportional hazards scale(PH model)were used to analyze the time-to-event data.Among 633 survivors,63.51%(n-402)had anterior circulation ischemia(ACI),and morc than half of all ACIs occurred in the subcortex.After a median follow-up of 2.5 years,117(18.48%)survivors developed a recurrent stroke.The results of the multivariate PH model showed that survivors with non-brain lesions were at higher risk of recurrence than those with right-side lesions(HR,2.79;95%CI,1.53,5.08;P-0.001).There was no increase in risk among survivors with left-side lesions(HR,0.97;95%CI,0.53,1.75;P=0.914)or both-side lesions(HR,1.24;95%CI,0.75,2.07;P-0.401)compared to those with right-side lesions.Additionally,there were no associations between stroke ecurrence and lesion locations that were classified based on vascular territory and brain anatomical structures.It was concluded that first-ever ischemic stroke survivors with non-brain lesion had higher recurrence risk than those with right-side lesion,although no significant associations were found when the lesion locations were classified by vascular territory and brain anatomical structures.

A plant-based diet and stroke

Stroke is a leading cause of death and disability in theUnited States and globally. Each year, approxirnately 795,000Americans experience a stroke.Total annual costs of stroke,both direct and indirect, amount to $33 billion. Ischemicstroke is predicted to cost more than $2.2 trillion between2005 and 2050. In the United States, 87% of all strokesare ischemic, 10% are due to intracerebral hemorrhage, and3% are due to subarachnoid hemorrhage.

Factors affecting rate of stroke-related death in elderly male military population A 23-year cohort study of 1268 cases in Xi'an,China

The study is the first long-term cohort study examining stroke and its subtypes among a population of Chinese elderly male retired military veterans. We reported on a 23-year cohort study examining stroke in 1 268 elderly male patients living in Xi＇an, China since 1987. The stroke-related mortality rate in this cohort was 361.50/1 x 106 per year. Cerebral hemorrhage was the dominant cause of death, with 28 cases of fatal cerebral infarction and 49 cases of fatal cerebral hemorrhage among 77 stroke-related deaths. Independent risk factors for stroke mortality included age, blood pressure, smoking, body mass index, family history of hypertension, past medical history of stroke, hypertension and hyperlipidemia. Among them, ischemic stroke mortality correlated with age, smoking, family history of hypertension and past medical history of stroke, while hemorrhagic stroke was related to blood pressure, body mass index and past medical history of hypertension. Our results indicated that maintaining appropriate levels of blood pressure and body mass, smoking cessation and prevention of hyperlipidemia can reduce the risk of stroke-related death in elderly males who are retired from military service.

Neuronal injury in the motor cortex after chronic stroke and lower limb motor impairment: a voxelbased lesion symptom mapping study

Many studies have examined motor impairments using voxel-based lesion symptom mapping, but few are reported regarding the corresponding relationship between cerebral cortex injury and lower limb motor impairment analyzed using this technique. This study correlated neuro- nal injury in the cerebral cortex of 16 patients with chronic stroke based on a voxel-based lesion symptom mapping analysis. Neuronal injury in the corona radiata, caudate nucleus and putamen of patients with chronic stroke could predict walking speed. The behavioral measure scores were consistent with motor deficits expected after damage to the cortical motor system due to stroke. These findings suggest that voxel-based lesion symptom mapping may provide a more accurate prognosis of motor recovery from chronic stroke according to neuronal injury in cerebral motor cortex.

Risk Factors and Prediction of Stroke in a Population with High Prevalence of Diabetes: The Strong Heart Study

Background and Objective: American Indians have a high prevalence of diabetes and higher incidence of stroke than that of whites and blacks in the U.S. Stroke risk prediction models based on data from American Indians would be of clinical and public health value. Methods and Results: A total of 3483 (2043 women) Strong Heart Study participants free of stroke at baseline were followed from 1989 to 2010 for incident stroke. Overall, 297 stroke cases (179 women) were identified. Cox models with stroke-free time and risk factors recorded at baseline were used to develop stroke risk prediction models. Assessment of the developed stroke risk prediction models regarding discrimination and calibration was performed by an analogous C-statistic (C) and a version of the Hosmer-Lemeshow statistic (HL), respectively, and validated internally through use of Bootstrapping methods. Results: Age, smoking status, alcohol consumption, waist circumference, hypertension status, antihypertensive therapy, fasting plasma glucose, diabetes medications, high/low density lipoproteins, urinary albumin/creatinine ratio, history of coronary heart disease/heart failure, atrial fibrillation, or Left ventricular hypertrophy, and parental history of stroke were identified as the significant optimal risk factors for incident stroke. Discussion: The models produced a C = 0.761 and HL = 4.668 (p = 0.792) for women, and a C = 0.765 and HL = 9.171 (p = 0.328) for men, showing good discrimination and calibration. Conclusions: Our stroke risk prediction models provide a mechanism for stroke risk assessment designed for American Indians. The models may be also useful to other populations with high prevalence of obesity and/or diabetes for screening individuals for risk of incident stroke and designing prevention programs.

Research progress of perioperative stroke

Perioperative stroke is one of the serious complications in perioperative patients,and its incidence is related to the risk factors of stroke,surgical methods,anesthesia,and surgical complexity.This article reviews the definition,incidence,risk factors,preventive measures,and management of perioperative patients of perioperative stroke,to provide a theoretical basis for clinical work,to reduce the incidence of perioperative stroke.

基于循证证据的脑卒中相关性肺炎预防措施在ICU急性缺血性脑卒中病人中的应用效果

目的:总结预防脑卒中相关性肺炎的循证证据并评价其临床应用效果。方法:选择2022年1月—12月安徽省某三级甲等医院神经内科ICU收治的59例急性缺血性脑卒中病人为研究对象,将2022年1月—5月收治的29例重症脑卒中病人为基线组,2022年8月—12月收治的30例重症脑卒中病人为循证实践组。以基于证据的持续质量改进模型作为理论框架,通过证据获取、现状审查、证据引入和效果评价4个阶段将脑卒中相关性肺炎预防的证据转化为临床实践。比较循证实践前后两组脑卒中病人脑卒中相关性肺炎的发生率、炎症指标和临床结局指标,以及循证实践前后医护人员预防脑卒中相关性肺炎证据认知水平变化。结果:最终纳入18条证据,并转化为10条审查指标。循证实践后,病人脑卒中相关性肺炎发生率及白细胞计数、C反应蛋白、ICU住院时间均明显降低(P<0.05)。循证实践后医护人员预防脑卒中相关性肺炎知识审查指标执行率均提高(P<0.05)。结论:以证据为基础的循证护理实践能够提高医护人员循证知识知晓率及对最佳证据的依从性,改善脑卒中病人的炎症指标,缩短ICU住院时间,降低脑卒中病人脑卒中相关性肺炎的发生率。