Inoue Yasuteru, Miyashita Fumio, Minematsu Kazuo, Toyoda Kazunori
Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
J Stroke Cerebrovasc Dis. 2018 Jan;27(1):97-102. doi: 10.1016/j.jstrokecerebrovasdis.2017.08.006. Epub 2017 Oct 12.
Intracerebral hemorrhage (ICH) incidences increase with age. Patients of advanced age may have limitations during acute care and recovery. We investigated baseline characteristics, hematoma features, and outcomes of very elderly ICH patients (≥80 years old) and compared them with those of younger ICH patients (<80 years old).
We studied 377 patients (122 women; 69 ± 11 years old) admitted within 24 hours of ICH onset. Outcome measures included hematoma volumes, National Institutes of Health Stroke Scale scores on admission, and vital and functional prognoses at 30 days.
After adjustments for sex, very elderly patients had a higher subcortical hematoma prevalence (odds ratio [OR], 2.62; 95% confidence interval [CI], 1.39-4.86]. On multivariate analyses, very elderly patients had larger hematoma volumes (OR, 1.33; 95% CI, 1.01-1.75, per 10-mL increase). After adjustments for risk factors and comorbidities, modified Rankin scale scores of 0-2 in very elderly patients occurred less often (OR, .34; 95% CI, .14-.82), and those with scores of 5-6 occurred more often (OR, 3.01; 95% CI, 1.09-8.54).
Hematomas were relatively large and often found in the subcortex in very elderly ICH patients. Outcomes of very elderly ICH patients were relatively poor.
脑出血(ICH)的发病率随年龄增长而增加。高龄患者在急性护理和康复期间可能存在局限性。我们调查了高龄脑出血患者(≥80岁)的基线特征、血肿特征和预后,并将其与年轻脑出血患者(<80岁)进行比较。
我们研究了377例在脑出血发病24小时内入院的患者(122例女性;年龄69±11岁)。结局指标包括血肿体积、入院时的美国国立卫生研究院卒中量表评分以及30天时的生命和功能预后。
在对性别进行调整后,高龄患者皮质下血肿的患病率更高(优势比[OR],2.62;95%置信区间[CI],1.39 - 4.86)。在多变量分析中,高龄患者的血肿体积更大(OR,1.33;95%CI,1.01 - 1.75,每增加10 mL)。在对危险因素和合并症进行调整后,高龄患者改良Rankin量表评分为0 - 2分的情况较少见(OR,0.34;95%CI,0.14 - 0.82),而评分为5 - 6分的情况更常见(OR,3.01;95%CI,1.09 - 8.54)。
高龄脑出血患者的血肿相对较大,且常位于皮质下。高龄脑出血患者的预后相对较差。