Mustanoja Satu, Satopää Jarno, Meretoja Atte, Putaala Jukka, Strbian Daniel, Curtze Sami, Haapaniemi Elena, Sairanen Tiina, Niemelä Mika, Kaste Markku, Tatlisumak Turgut
Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland.
Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland.
Int J Stroke. 2015 Jun;10(4):576-81. doi: 10.1111/ijs.12437. Epub 2015 Jan 12.
Intraventricular hemorrhage is a severe subtype of intracerebral hemorrhage associated with high mortality and poor outcome.
We analyzed various intraventricular hemorrhage scores at baseline to find common parameters associated with increased mortality.
Consecutive intracerebral hemorrhage patients treated in Helsinki University Central Hospital during 2005-2010 were included in the Helsinki Intracerebral Hemorrhage Study registry and analyzed for three-month mortality.
After excluding lost-to-follow-up patients, 967 intracerebral hemorrhage patients were included, out of whom 398 (41%) had intraventricular hemorrhage. Intraventricular hemorrhage patients, compared with nonintraventricular hemorrhage patients, had lower baseline Glasgow Coma Scale [median 12 (IQR 6-15) vs. 15 (13-15); P < 0.001] and higher National Institutes of Health Stroke Scale [18 (10-27) vs. 7 (3-14); P < 0.001] scores; larger intracerebral hemorrhage volumes [17 ml (7.2-42) vs. 6.8 (2.4-18); P < 0.001] and more often hydrocephalus (51% vs. 9%; P < 0.001); and higher mortality rates (54% vs. 18%; P < 0.001). In multivariable analysis, the presence of intraventricular hemorrhage was independently associated with mortality [OR 2.05 (95% CI 1.36-3.09)] when adjusted for well-known prognostic factors of intracerebral hemorrhage, i.e. age, gender, baseline National Institutes of Health Stroke Scale, intracerebral hemorrhage volume, infratentorial location, and etiology.
The presence of intraventricular hemorrhage was independently associated with increased mortality, and all the intraventricular hemorrhage scores were strong predictors of three-month mortality.
脑室内出血是脑出血的一种严重亚型，与高死亡率和不良预后相关。
我们在基线时分析了各种脑室内出血评分，以找出与死亡率增加相关的共同参数。
2005年至2010年在赫尔辛基大学中心医院接受治疗的连续性脑出血患者被纳入赫尔辛基脑出血研究登记处，并对其三个月死亡率进行分析。
在排除失访患者后，纳入了967例脑出血患者，其中398例（41%）有脑室内出血。与非脑室内出血患者相比，脑室内出血患者的基线格拉斯哥昏迷量表评分较低[中位数12（四分位间距6 - 15）对15（13 - 15）；P < 0.001]，美国国立卫生研究院卒中量表评分较高[18（10 - 27）对7（3 - 14）；P < 0.001]；脑出血体积较大[17 ml（7.2 - 42）对6.8（2.4 - 18）；P < 0.001]，脑积水更为常见（51%对9%；P < 0.001）；死亡率更高（54%对18%；P < 0.001）。在多变量分析中，在对脑出血的已知预后因素，即年龄、性别、基线美国国立卫生研究院卒中量表、脑出血体积、幕下位置和病因进行校正后，脑室内出血的存在与死亡率独立相关[比值比2.05（95%可信区间1.36 - 3.09）]。
脑室内出血的存在与死亡率增加独立相关，所有脑室内出血评分都是三个月死亡率的强有力预测指标。
