Early in-patient MR Imaging may assist in identifying stroke etiology, facilitating prompt secondary prevention for ischemic strokes (IS), and potentially enhancing patient outcomes. This study explores the impact of early in patient MRI on IS patient outcomes and healthcare resource use beyond the hyper-acute stage. In this retrospective registry-based study, 771 admitted transient ischemic attack (TIA) and IS patients at Halifax's QEII Health Centre from 2015 to 2019 underwent in-patient MRI. Cohort was categorized into two groups based on MRI timing: early (within 48 hours) and late. Logistic regression and Poisson log-linear models, adjusted for age, sex, stroke severity, acute stroke protocol (ASP) activation, thrombolytic, and thrombectomy, were employed to examine in-hospital, discharge, post-discharge, and healthcare resource utilization outcomes. Among the cohort, 39.6% received early in-patient MRI. ASP activation and TIA were associated with a higher likelihood of receiving early MRI. Early MRI was independently associated with a lower rate of symptomatic changes in neurological status during hospitalization (adjusted odds ratio [OR], 0.42; 95% confidence interval [CI], 0.20–0.88), higher odds of good functional outcomes at discharge (1.55; 1.11–2.16), lower rate of non-home discharge (0.65; 0.46–0.91), shorter length of stay (regression coefficient, 0.93; 95% CI, 0.89–0.97), and reduced direct cost of hospitalization (0.77; 0.75–0.79). Early in-patient MRI utilization in IS patients post-hyper-acute stage was independently associated with improved patient outcomes and decreased healthcare resource utilization, underscoring the potential benefits of early MRI during in-patient management of IS. Further research, including randomized controlled trials, is warranted to validate these findings.

中文翻译：

---

早期 MRI 对超急性期后缺血性中风的影响，可改善患者预后、实现早期出院并节省成本

早期住院患者 MR 成像可能有助于确定中风病因，促进缺血性中风 (IS) 的及时二级预防，并可能改善患者预后。本研究探讨了早期患者 MRI 对 IS 患者预后和超急性阶段后医疗资源使用的影响。在这项基于登记的回顾性研究中，2015 年至 2019 年哈利法克斯 QEII 健康中心入院的 771 名短暂性脑缺血发作 (TIA) 和 IS 患者接受了住院 MRI 检查。根据 MRI 时间将队列分为两组：早期（48 小时内）和晚期。采用逻辑回归和泊松对数线性模型，根据年龄、性别、卒中严重程度、急性卒中方案 (ASP) 激活、溶栓和血栓切除术进行调整，用于检查住院、出院、出院后和医疗资源利用结果。在该队列中，39.6% 的人接受了早期住院 MRI 检查。ASP 激活和 TIA 与接受早期 MRI 的可能性较高相关。早期 MRI 与住院期间神经状态症状变化率较低（调整后比值比 [OR]，0.42；95% 置信区间 [CI]，0.20–0.88）、出院时良好功能结果的几率较高（1.55）独立相关。 ; 1.11–2.16），较低的非家庭出院率（0.65；0.46–0.91），较短的住院时间（回归系数，0.93；95% CI，0.89–0.97），以及降低的直接住院费用（0.77；0.75） –0.79）。超急性期后 IS 患者的早期住院 MRI 使用与患者预后的改善和医疗资源利用率的降低独立相关，这强调了 IS 住院治疗期间早期 MRI 的潜在益处。有必要进行进一步的研究，包括随机对照试验来验证这些发现。