一种用于预测脑出血患者住院死亡率的新简单模型。
A new simple model for prediction of hospital mortality in patients with intracerebral hemorrhage.
机构信息
Department of Cardiology, the Second Hospital of Shanxi Medical University, Taiyuan, China.
出版信息
CNS Neurosci Ther. 2012 Jun;18(6):482-6. doi: 10.1111/j.1755-5949.2012.00320.x.
BACKGROUND
The current prognostic models for mortality and functional outcome after intracerebral hemorrhage (ICH) are not simple enough. To predict the outcome of ICH, a new simple model, ICH index (ICHI), was established and evaluated in this study.
METHODS
Medical records of all cases with ICH in our hospital from January 2008 to August 2009 were reviewed. Multiple linear regression analyses were used to assess the contributions of independent variables to hospital mortality after ICH.
RESULTS
Age, serum glucose, white blood cell counts (WBC), and Glasgow Coma Scale (GCS) score were found to be greatly associated with mortality. A formula of ICH index [ICHI = age (years)/10 + glucose (mmol/L) + WBC (10(9) /L) - GCS score] was established. Furthermore, the receiver operating characteristic (ROC) analyses were performed to estimate the predictive value of the ICHI. The model showed an area under the ROC curve (AURC) of 0.923 (95% CI: 0.883-0.963, P < 0.001). The best cut-off value of ICHI for mortality was 18, which gave sensitivity, specificity, and Youden's index of 0.65, 0.95, and 0.60, respectively. The hospital mortality was extremely increased when 18 < ICHI < 28 (mortality 72.0%) and when ICHI ≥ 28 (mortality 100%), in contrast with overall mortality (21.6%).
CONCLUSION
The ICHI can be a simple predictive model and complementary to other prognostic models.
背景
目前用于预测脑出血（ICH）后死亡率和功能结局的预后模型不够简单。为了预测ICH 的结果，本研究建立并评估了一个新的简单模型，ICH 指数（ICHI）。
方法
回顾了我院 2008 年 1 月至 2009 年 8 月所有 ICH 病例的病历。使用多元线性回归分析评估独立变量对 ICH 后住院死亡率的贡献。
结果
年龄、血清葡萄糖、白细胞计数（WBC）和格拉斯哥昏迷量表（GCS）评分与死亡率密切相关。建立了 ICH 指数公式[ICHI=年龄（岁）/10+葡萄糖（mmol/L）+WBC（10（9）/L）-GCS 评分]。此外，还进行了受试者工作特征（ROC）分析以评估 ICHI 的预测价值。该模型的 ROC 曲线下面积（AURC）为 0.923（95%CI：0.883-0.963，P<0.001）。ICHI 对死亡率的最佳截断值为 18，其敏感性、特异性和 Youden 指数分别为 0.65、0.95 和 0.60。当 18<ICHI<28 时（死亡率 72.0%）和 ICHI≥28 时（死亡率 100%），住院死亡率极高，而总体死亡率为 21.6%。
结论
ICHI 可以作为一个简单的预测模型，与其他预后模型互补。
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