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基于医院登记系统的首次原发性脑桥出血的三年预后

Three-year prognosis of first-ever primary pontine hemorrhage in a hospital-based registry.

作者信息

Ye Zusen, Huang Xiaoya, Han Zhao, Shao Bei, Cheng Jianhua, Wang Zhen, Zhang Zheng, Xiao Meijuan

机构信息

Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, 2 Fuxue Lane, Wenzhou, Zhejiang Province 325000, People's Republic of China.

Department of Neurology, Wenzhou Central Hospital and Dingli Clinical Institute of Wenzhou Medical University, Wenzhou, Zhejiang Province, People's Republic of China.

出版信息

J Clin Neurosci. 2015 Jul;22(7):1133-8. doi: 10.1016/j.jocn.2014.12.024. Epub 2015 May 14.

Abstract

Our aim was to evaluate the mortality rate of primary pontine hemorrhage (PPH) and to determine the factors related to the prognosis. Limited data exist on the long-term prognosis and determinants of death in patients with PPH in China. Our study analyzed consecutive cases of first-ever PPH from April 2007 to March 2011 in a hospital-based stroke registry. Mortality rates during 30 day and 3 year follow-ups were analyzed. We used the Kaplan-Meier method to estimate the event rates and binary logistic regression analysis, and Cox proportional hazard regression analysis to identify predictors of short-term and long-term prognosis, respectively. A total of 76 patients were identified, 44 (57.89%) were men. Both 30 day and 3 year overall mortalities in men were higher than women but this different was not statistically significant. Coma on admission, hematoma ⩾ 4 mL and a massive hemorrhage were significantly related to 30 day mortality of PPH. Multivariate Cox proportional hazard regression revealed that coma on admission (hazard ratio [HR] 2.18; 95% confidence interval [CI] 1.16-4.13; p = 0.02) and hematoma ⩾ 4 mL (HR 2.23; 95% CI 1.25-3.96; p = 0.01) were independent predictors of 3 year mortality. In conclusion, the short-term mortality rate and factors related to the prognosis of Chinese patients with PPH are similar to those reported for other populations. A low Glasgow coma scale score on admission and a large hematoma volume may be related to poor 3 year prognosis after PPH.

摘要

我们的目的是评估原发性脑桥出血(PPH)的死亡率,并确定与预后相关的因素。在中国,关于PPH患者的长期预后和死亡决定因素的数据有限。我们的研究分析了2007年4月至2011年3月在一家医院卒中登记处首次发生PPH的连续病例。分析了30天和3年随访期间的死亡率。我们使用Kaplan-Meier方法估计事件发生率,并进行二元逻辑回归分析,以及Cox比例风险回归分析,分别确定短期和长期预后的预测因素。共确定了76例患者,其中44例(57.89%)为男性。男性的30天和3年总死亡率均高于女性,但这种差异无统计学意义。入院时昏迷、血肿≥4 mL和大量出血与PPH的30天死亡率显著相关。多变量Cox比例风险回归显示,入院时昏迷(风险比[HR] 2.18;95%置信区间[CI] 1.16 - 4.13;p = 0.02)和血肿≥4 mL(HR 2.23;95% CI 1.25 - 3.96;p = 0.01)是3年死亡率的独立预测因素。总之,中国PPH患者的短期死亡率及与预后相关的因素与其他人群报道的相似。入院时格拉斯哥昏迷量表评分低和血肿量大可能与PPH后3年预后不良有关。

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