| Background:In-hospital ischemic stroke refers to patients hospitalized for diseases other than acute stroke.New ischemic stroke during hospitalization accounts for 2% ～ 17% of all ischemic strokes.Compared with out-of-hospital stroke,which is often complicated by many diseases,it tends to have a lower rate of thrombolysis and a greater risk of disability or death.Objective:To explore the high-risk factors,types,vascular involvement,treatment and prognosis of ischemic stroke in our hospital,so as to improve the vigilance and early recognition of hospital ischemic stroke in all clinical departments,and achieve reasonable and timely intervention.Subjects and methods:A retrospective analysis of 142 patients with in-hospital ischemic stroke in the Second Affiliated Hospital of Guangzhou Medical University from January 2016 to January 2021 was conducted.The hospitalization data of the patients included gender,age,smoking,previous stroke history,hypertension,diabetes,hyperlipidemia,atrial fibrillation,infection,cancer,department distribution of onset,perioperative period,stroke type and location,treatment options and prognosis,etc.Results:1.Among 142 cases of in-hospital ischemic stroke,68 cases were female(47.9%)and 74 cases were male(52.1%),and the incidence of male was slightly higher than that of female.2.Cardiovascular Department is the main department of ischemic stroke in our hospital.3.The average time from onset to diagnosis of ischemic stroke in our hospital was9.5h.4.The first clinical manifestations were limb weakness and consciousness disturbance,followed by speech disturbance(71 cases,45 cases,24 cases).5.Among all the included patients with ischemic stroke in hospital,30 cases showed single lesion and 112 cases showed multi-site infarct on imaging.6.Intravenous thrombolysis was performed in 8 patients with in-hospital ische-mic stroke,while endovascular treatment was performed in 8 patients.7.Prognosis: 23 cases were better and discharged,15 cases died,and 104 cases were physically handicapped to varying degrees at discharge.8.Analysis of predictive risk factors in the in-hospital ischemic stroke group and the nosocomial non-stroke group showed that hypertension,diabetes mellitus,advanced age,atrial fibrillation,hyperlipidemia,previous stroke history,infection and Perioperative period were all correlated with the incidence of nosocomial ischemic stroke,and the analysis was further included in the binary logistic regression model.Atrial fibrillation,hyperlipidemia,previous stroke history,infection,perioperative period were significantly associated with the risk factors of nosocomial ischemic stroke.Conclusion:1.The incidence of acute ischemic stroke in our hospital is highest in cardiovascular department.2.The poor prognosis of most patients with in-hospital ischemic stroke is associated with delayed diagnosis and low probability of effective reperfusion after the onset of the stroke.3.Age,atrial fibrillation,hyperlipidemia,previous stroke history,infection,and perioperative period were the risk factors for in-hospital ischemic stroke.4.Hypertension,diabetes mellitus,age,atrial fibrillation,hyperlipide-ma,previous stroke history,infection and perioperative period are related to the incidence of hospital ischemic stroke.Clinically,stroke risk assessment should be routinely conducted for these patients,especially for patients with hypertension,diabetes,hyperlipidemia and other modifiable risk factors for ischemic stroke.Secondary preventive treatment,such as lowering blood pressure,lowering blood glucose and controlling blood lipids,is required. |
