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脑出血患者的预后:生存预测因素

Outcome in patients with intracerebral hemorrhage: predictors of survival.

作者信息

Karnik R, Valentin A, Ammerer H P, Hochfelner A, Donath P, Slany J

机构信息

2nd Department of Medicine, Krankenanstalt Rudolfstifung, Vienna, Austria.

出版信息

Wien Klin Wochenschr. 2000 Feb 25;112(4):169-73.

Abstract

BACKGROUND AND PURPOSE

The aim of this retrospective study was to determine in-hospital mortality and morbidity secondary to intracerebral hemorrhage and to analyse variables considered to be significantly associated with survival in these patients.

PATIENTS AND METHODS

The study cohort consisted of 135 consecutive patients with intracerebral hemorrhage, admitted to a large community hospital in the urban area of Vienna. The diagnosis of intracerebral hemorrhage was established in all cases with axial computed tomography. The following variables were analysed: age, sex, Glasgow coma score on admission, location of hematomas, intraventricular hemorrhage, neurosurgical interventions and medical complications.

RESULTS

Sixty-seven (49.6%) of the 135 patients died, 50 (37%) of them during the first 4 days after the acute event, 13 within the 1st week and 4 within one month. In a multivariate analysis the risk of death was significantly increased by the presence of intraventricular hemorrhage (p < 0.01), a Glasgow coma score of 6 or less (p < 0.0001) and age greater than 60 years (p < 0.001). Gender, medical complications and surgical removal of hemorrhage with or without additional ventriculostomy did not correlate significantly with outcome while an infratentorial location of hematoma showed a trend (p < 0.15) towards a higher mortality.

CONCLUSION

A Glasgow coma score of 6 or less on admission, age greater than 60 years and the presence of intraventricular hemorrhage appear to be predictors of mortality in patients with intracerebral hemorrhage.

摘要

背景与目的

本回顾性研究旨在确定脑出血继发的院内死亡率和发病率,并分析被认为与这些患者生存显著相关的变量。

患者与方法

研究队列包括135例连续的脑出血患者,他们被收治于维也纳市区的一家大型社区医院。所有病例均通过轴向计算机断层扫描确诊脑出血。分析了以下变量:年龄、性别、入院时的格拉斯哥昏迷评分、血肿位置、脑室内出血、神经外科干预措施和医疗并发症。

结果

135例患者中有67例(49.6%)死亡,其中50例(37%)在急性事件发生后的前4天内死亡,13例在第1周内死亡,4例在1个月内死亡。多因素分析显示,脑室内出血(p < 0.01)、格拉斯哥昏迷评分为6分或更低(p < 0.0001)以及年龄大于60岁(p < 0.001)会显著增加死亡风险。性别、医疗并发症以及有无额外脑室造瘘的出血手术清除与预后无显著相关性,而幕下血肿位置显示出死亡率较高的趋势(p < 0.15)。

结论

入院时格拉斯哥昏迷评分为6分或更低、年龄大于60岁以及存在脑室内出血似乎是脑出血患者死亡率的预测因素。

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