Retrospective analysis of comorbidities in stroke patients with a history of obstructive sleep apnea treated with thrombolytic therapy.
J Vasc Nurs
; 40(2): 74-85, 2022 06.
Article
em En
| MEDLINE
| ID: mdl-35750378
ABSTRACT
BACKGROUND:
The eligibility criteria for thrombolytic therapy may differ between acute ischemic stroke patients (AIS) patients with and without incidence of obstructive sleep apnea (OSA). In this study, we determine the effect of specific comorbidities in the exclusion and inclusion for recombinant tissue plasminogen activator (rtPA) administration in the AIS population with OSA.METHODS:
Retrospective data from a stroke registry were analyzed for baseline clinical and demographic factors in AIS patients with OSA for rtPA therapy from January 2010 to June 2016. The logistic regression model was developed to identify each of the variables predicting inclusion for or exclusion from rtPA. We estimated the odds of the inclusion or exclusion of a particular demographic and clinical risk factor in AIS with and without OSA for rtPA therapy. The validity of the model was tested using a Hosmer-Lemeshow test and the sensitivity of the model was determined using a Receiver Operating Curve (ROC).RESULTS:
A total of 170 AIS patients with OSA were identified, of which, 125 did not receive rtPA while 45 received rtPA. Adjusted analysis showed that in the AIS population with OSA, administration of rtPA was associated with a history of dyslipidemia (OR=3.192, 95% CI, 1.148-8.88, p=0.026), direct admission into a Comprehensive Stroke Center (OR=3.248, 95% CI, 1.06-9.95, p=0.039), and ambulatory improvement (OR=3.556, 95% CI, 1.428-8.86, p=0.006). There were no significant factors associated with rtPA exclusion in the AIS population with OSA.CONCLUSION:
The prevalence of OSA in our AIS population was low and no clinical risk factor was associated with the exclusion of patients with AIS and OSA from thrombolytic therapy. Future studies are necessary to explore the effect of OSA in AIS patients to improve eligibility for rtPA therapy for more patients.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Isquemia Encefálica
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Apneia Obstrutiva do Sono
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Acidente Vascular Cerebral
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AVC Isquêmico
Tipo de estudo:
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
J Vasc Nurs
Assunto da revista:
ANGIOLOGIA
/
ENFERMAGEM
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Estados Unidos