Tu C J, Liu J S, Song D G, Zhen G, Luo H M, Liu W G, Dong X Q
Department of Neurosurgery, Shaoxing County Central Hospital, Shaoxing, China.
J Int Med Res. 2011;39(5):1757-65. doi: 10.1177/147323001103900518.
This study was designed to evaluate whether the maximum thickness of subarachnoid blood is an independent prognostic marker of mortality after traumatic subarachnoid haemorrhage. Multivariate analysis showed the maximum thickness of subarachnoid blood was an independent predictor of death versus survival 1 month after injury and was inversely associated with Glasgow Coma Scale (GCS) score. Receiver operating characteristic curve analysis showed that maximum thickness of subarachnoid blood > 6.7 mm immediately after non-surgical resuscitation predicted 1-month mortality with 83.9% sensitivity and 67.1% specificity; its predictive value was similar to that of the GCS score. Addition of maximum thickness of subarachnoid blood to the GCS score did not significantly improve predictive performance. Hence, the maximum thickness of subarachnoid blood is a new independent prognostic marker of mortality and might become an additional, valuable tool for risk stratification and decision making in the acute phase of traumatic subarachnoid haemorrhage.
本研究旨在评估蛛网膜下腔出血的最大厚度是否为创伤性蛛网膜下腔出血后死亡的独立预后标志物。多因素分析显示，蛛网膜下腔出血的最大厚度是伤后1个月死亡与存活的独立预测因素，且与格拉斯哥昏迷量表（GCS）评分呈负相关。受试者工作特征曲线分析表明，非手术复苏后即刻蛛网膜下腔出血最大厚度>6.7 mm预测1个月死亡率的敏感度为83.9%，特异度为67.1%；其预测价值与GCS评分相似。将蛛网膜下腔出血最大厚度加入GCS评分并未显著提高预测性能。因此，蛛网膜下腔出血的最大厚度是死亡的一种新的独立预后标志物，可能成为创伤性蛛网膜下腔出血急性期风险分层和决策的一种额外的、有价值的工具。
