Published online Oct 16, 2022. doi: 10.12998/wjcc.v10.i29.10478
Peer-review started: July 3, 2022
First decision: August 1, 2022
Revised: August 12, 2022
Accepted: August 30, 2022
Article in press: August 30, 2022
Published online: October 16, 2022
Posterior circulation cerebral infarction (PCCI) occurs in the blood-supply region of the vertebral basilar artery system. PCCI represents a fifth of all acute ischemic stroke cases, and the prognosis is extremely poor, with a mortality of nearly 90%. Close cooperation between doctors and nurses is key to ensuring smooth progress in diagnosis and treatment. It is necessary to develop a clinical continuity management model to provide better health services for patients with PCCI.
This study explored the effect of the application of the medical care linkage-continuous management mode (MCLMM) in patients with PCCI undergoing endovascular intervention to provide theoretical evidence for the innovation of this nursing model.
We adopted a MCLMM based on the strengthening of medical and nursing cooperation. This is a new attempt to demonstrate the application of a MCLMM to improve the prognosis of PCCI.
Sixty-nine patients with PCCI who received endovascular interventional therapy and conventional nursing intervention were selected as the control group and 78 patients with PCCI who received endovascular interventional therapy and medical care linkage-based continuous management intervention were selected as the observation group. The incidence of postoperative complications and compliance and disease self-management behavior after six months of intervention, modified Rankin scale (mRS) and Barthel index (BI) scores in the acute phase and after one year of intervention, and recurrence within one year were compared between the two groups.
The total incidence rate of postoperative complications in the observation group (7.69%) was significantly lower than that in the control group (18.84%). Scores for medical compliance behavior (regular medication, reasonable diet, and rehabilitation cooperation rates) and disease self-management behavior (self-will, disease knowledge, and self-care ability) in the observation group were significantly higher than those in the control group. After one year of intervention, the mRS score in the observation group was significantly lower, and the BI score was significantly higher, than the corresponding scores in the control group. The recurrence rate within one year in the observation group (3.85%) was significantly lower than that in the control group (13.04%).
The MCLMM can effectively reduce the incidence of postoperative complications after vascular intervention for PCCI and significantly improve the compliance behavior and disease self-management ability of patients. It can significantly promote the recovery of neurological function and daily living ability of patients, and prevent disease recurrence. Thus, it is worthy of clinical application.
A variety of factors influence the clinical prognosis of endovascular mechanical thrombectomy treatment for PCCI. The MCLMM can improve quality of life and play an important role in improving prognosis, which could be widely applied in the health industry in the future by combining various biological indicators.