Delayed decision making of intravenous thrombolysis in elderly patients with acute cerebral infarction and related influencing factors
Objective To investigate the status quo of delayed intravenous thrombolysis(IVT)decision making and related influ-encing factors in elderly patients with acute cerebral infarction(ACI).Methods Clinical data of 291 elderly ACI patients receiving IVT in our hospital from April 2021 to April 2023 were collected and retrospectively analyzed.The reasons of delayed decision for IVT were analyzed,and the delayed decision time was compared in the patients with different clinical characteristics.Multivariate logistic regression analysis was used to analyze the risk factors of delayed IVT decision in elderly ACI patients.SPSS statistics 22.0 was employed for statistical analysis.Independent sample t test was utilized for comparison between two groups,one-way analysis of variance for comparison among multiple groups,and LSD-t test for pairwise comparisons.Results In the 291 elderly ACI patients,the main reason for delayed decision making was lack of disease-related knowledge,accounting for 40.55%(118/291),and the decision time of IVT was(34.28±10.40)min for these patients and their families.The results of univariate analysis showed that there were no significant differences in gender,time from onset to admission,monthly family income,awareness of ACI occurrence,first onset,severity of symptoms,and intravenous thrombolytic therapy between two groups,but significant differences were observed in age,decision-makers,whether they had received the relevant knowledge of disease,whether they paid attention to the risk factors of disease and active prevention for ACI in the elderly(P<0.05).Multivariate logistic regression analysis indicated that age≥70 years(OR=3.420,95%CI 1.273-9.188;P=0.015),patients and their families as decision makers(OR=1.244,95%CI 1.037-1.492;P=0.019),not receiving disease-related knowledge in the past(OR=4.579,95%CI 1.507-13.913;P=0.007),no attention to the risk factors of disease occurrence and active prevention(OR=2.333,95%CI 1.148-4.741;P=0.019)were risk factors for delayed IVT decision in elderly ACI patients.Conclusion The delayed decision of IVT therapy in elderly ACI patients is affected by many factors.Clinical identification and corresponding intervention should be taken in combination with relevant factors.
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