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急性自发性小脑出血患者第一周死亡率的预测因素。

Predictors of first-week mortality in patients with acute spontaneous cerebellar hemorrhage.

机构信息

Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, No. 325, Sec. 2, Cheng-Kung Road, Neihu District, Taipei, Taiwan.

出版信息

Cerebellum. 2013 Apr;12(2):165-70. doi: 10.1007/s12311-012-0410-6.

Abstract

Cerebellar hemorrhage (CH) is considered a predictive factor for poor outcome after intracranial hemorrhage because of the high risk of brainstem compression. Hence, predictors of early mortality in patients with spontaneous CH are clinically valuable. However, the predictors of death within 7 days of CH onset have not yet been studied. In this study, 70 patients with acute spontaneous CH were retrospectively analyzed. The patients were divided into the first-week mortality group (n = 15, died within 7 days) and survival group (n = 55, survived at discharge). The association between first-week mortality and clinical characteristics was investigated using a multivariate logistic regression. The initial Glasgow coma scale (GCS) values (5.0 ± 2.8) in the first-week mortality group were significantly lower than those in the survival group (12.8 ± 3.3) (p < 0.001). Brainstem compression was indicative of first-week mortality (p < 0.001). GCS scores ≤8 (odds ratio, OR = 32.344, p = 0.003) and brainstem compression (OR = 14.417, p = 0.009) were strong predictors of first-week mortality in patients with CH. This is the first study showing that GCS scores ≤8 on arrival and brainstem compression are strong predictive factors for first-week mortality in patients with CH. These patients were about 32 and 14.5 times, respectively, more likely to die within 7 days.

摘要

小脑出血(CH)被认为是颅内出血后预后不良的预测因素,因为其存在脑干压迫的高风险。因此,自发性 CH 患者早期死亡率的预测因素在临床上具有重要价值。然而,CH 发病后 7 天内死亡的预测因素尚未被研究。在本研究中,回顾性分析了 70 例急性自发性 CH 患者。患者分为第 1 周死亡率组(n = 15,7 天内死亡)和生存组(n = 55,出院时存活)。采用多变量逻辑回归分析第 1 周死亡率与临床特征的关系。第 1 周死亡率组的初始格拉斯哥昏迷量表(GCS)评分(5.0 ± 2.8)明显低于生存组(12.8 ± 3.3)(p < 0.001)。脑干压迫提示第 1 周死亡率(p < 0.001)。GCS 评分≤8(比值比,OR = 32.344,p = 0.003)和脑干压迫(OR = 14.417,p = 0.009)是 CH 患者第 1 周死亡率的强烈预测因素。这是第一项表明入院时 GCS 评分≤8 和脑干压迫是 CH 患者第 1 周死亡率的强烈预测因素的研究。这些患者在 7 天内死亡的风险分别约为 32 倍和 14.5 倍。

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