Roquer Jaume, Rodríguez Campello Ana, Gomis Meritxell, Ois Angel, Puente Victor, Munteis Elvira
Unitat d'Ictus, Servei de Neurología, Hospital del Mar, Passeig Marítim 25-29, 08003 Barcelona, Spain.
J Neurol. 2005 Apr;252(4):412-6. doi: 10.1007/s00415-005-0659-5. Epub 2005 Mar 3.
Intracerebral hemorrhage (ICH) constitutes 10% to 15% of all strokes. Despite several existing outcome prediction models for ICH, there are some factors with equivocal value as well as others that still have not been evaluated.
All patients with first ever supratentorial ICH presenting to our institution between December 1995 and December 2002 were prospectively enrolled into the study. Patients with historic modified Rankin Scale > 2 and those under anticoagulant treatment or with multiple ICH were excluded. The following parameters were analyzed in 194 consecutive patients: age, gender, past history of hypertension, diabetes mellitus, hypercholesterolemia, past history of ischemic stroke, presence of ischemic heart disease or cardioembolic disease, current antiplatelet treatment, current alcohol overuse, smoking, Glasgow Coma Scale score (GSS) at admission, volume and location (deep or lobar) of ICH, ventricular extension, glycemia and temperature at admission, and leukoaraiosis. We correlated these data with the 30-day mortality identifying the independent predictors by logistic regression analysis.
Factors independently associated with 30-day mortality were: age, Glasgow Coma Scale score at admission, ICH volume, ventricular extension, glucose level at admission, and previous antiplatelet use.
Apart from the classical outcome predictors, the previous use of antiplatelet agents and the glucose value at admission are independent predictors of 30-day mortality in patients suffering a supratentorial ICH.
脑出血（ICH）占所有中风的10%至15%。尽管现有多种脑出血的预后预测模型，但仍有一些因素的价值存在争议，还有一些因素尚未得到评估。
1995年12月至2002年12月期间在本机构首次发生幕上脑出血的所有患者均被前瞻性纳入研究。排除改良Rankin量表评分>2的患者、接受抗凝治疗的患者或多发性脑出血患者。对194例连续患者分析了以下参数：年龄、性别、高血压病史、糖尿病史、高胆固醇血症病史、缺血性中风病史、缺血性心脏病或心源性栓塞性疾病的存在、当前抗血小板治疗情况、当前酒精过度使用情况、吸烟情况、入院时格拉斯哥昏迷量表评分（GCS）、脑出血体积和位置（深部或脑叶）、脑室扩展情况、入院时血糖和体温以及脑白质疏松症。我们通过逻辑回归分析将这些数据与30天死亡率相关联，以确定独立预测因素。
与30天死亡率独立相关的因素为：年龄、入院时格拉斯哥昏迷量表评分、脑出血体积、脑室扩展、入院时血糖水平以及既往抗血小板药物使用情况。
除了经典的预后预测因素外，既往抗血小板药物的使用和入院时的血糖值是幕上脑出血患者30天死亡率的独立预测因素。
