Abstract: In-hospital stroke is defined as new-onset acute stroke occurring in hospitalized patients admitted for other disease diagnosis or procedure. The most common stroke subtype is in-hospital ischemic stroke. The risk factors and mechanism of in-hospital ischemic stroke are more complex than community-onset stroke. In addition to thromboembolism, hypoperfusion and hypercoagulability, iatrogenic complications of procedures are also one of the important causes. Patients with in-hospital stroke have worse outcomes and higher mortality than patients with community-onset stroke. The multiple comorbidities, larger volume infarct due to embolism and lower reperfusion rate were key factors for poor prognosis. Early identification of in-hospital stroke and timely initiation of stroke fast tract are important factors affecting the treatment effect, which are also the focus of the construction of in-hospital stroke emergency system; in addition, improving the rate of reperfusion therapy in perioperative patients is also an important aspect in the construction of in-hospital stroke emergency system. The procedure and system of in-hospital stroke care in China need to be improved, which need more multi-center study evidence to support for establishing and improving in-hospital ischemic stroke care system, so as to increase the reperfusion rate and improve the prognosis of patients.

Key words: In-hospital stroke; Ischemic stroke; Risk factor; Reperfusion treatment; Quality control

摘要： 院内卒中是指因其他疾病住院的患者在住院期间发生的急性卒中,其中最常见的类型是缺 血性卒中。与社区卒中相比，院内缺血性卒中的危险因素和发病机制更为复杂，除了栓塞、低灌注、高 凝状态，医源性因素也是重要的致病原因之一。院内缺血性卒中患者的不良功能预后和死亡率均较 社区患者显著增高，研究提示基础疾病较多、围手术期栓塞所致脑梗死范围更大以及再灌注治疗率 较低等因素均是预后不良的重要原因。早期识别卒中并快速启动绿色通道是影响院内卒中救治效果 的重要因素，也是院内卒中急救体系建设的重点；另外，提高再灌注治疗率也是院内卒中急救体系建 设的重要方面。我国院内卒中救治的流程和体系尚未建设完善，后续需要多中心参与的相关研究为建 立和完善院内卒中急救体系，提高缺血性卒中的再灌注治疗率，改善患者预后提供证据支持。

关键词: 院内卒中; 缺血性卒中; 危险因素; 再灌注治疗; 质量控制