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[自发性脑出血生命预后的多因素研究方法]

[A multi-factorial approach in the vital prognosis of spontaneous intracerebral hematoma].

作者信息

Senant J, Samson M, Proust B, Szeibert J, Onnient Y

机构信息

Clinique Neurologique, CHU de Rouen.

出版信息

Rev Neurol (Paris). 1988;144(4):279-83.

PMID:3047834
Abstract

The prognostic assessment of a patient with intra-cerebral hemorrhage (IH) requires simultaneous appraisal of several parameters. We have attempted this with a multivariate method: discriminant analysis. We studied retrospectively 142 patients with non-operated IH, not due to vascular malformation, distributed two months after the initial event in two groups: 92 living patients and 50 dead. Discriminant analysis of 21 parameters from the initial examination and CT scan, selected five factors which best separate the two groups, since 89% of the patients were well classified. These five parameters (age, consciousness impairment, temperature, volume of the hematoma and ventricular hemorrhage) combined, give a prognostic score which gives for each patient his probability of survival or death. The validity of the proposed model was controlled on a test-sample of 66 patients from another department. The possibility of giving a trustworthy spontaneous prognosis on the first day can enable the evaluation of the possible benefit from surgery, which we illustrated with a group of 23 operated patients.

摘要

对脑出血(IH)患者进行预后评估需要同时评估多个参数。我们尝试用多变量方法:判别分析来进行评估。我们回顾性研究了142例非因血管畸形导致的非手术性脑出血患者,在初始事件发生两个月后将其分为两组:92例存活患者和50例死亡患者。对初始检查和CT扫描的21个参数进行判别分析,选出了最能区分两组的五个因素,因为89%的患者得到了很好的分类。这五个参数(年龄、意识障碍、体温、血肿体积和脑室出血)综合起来,给出了一个预后评分,该评分能为每个患者给出其生存或死亡的概率。在来自另一个科室的66例患者的测试样本上验证了所提出模型的有效性。在第一天给出可靠的自发预后的可能性能够评估手术可能带来的益处,我们用一组23例接受手术的患者对此进行了说明。

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