Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
J Stroke Cerebrovasc Dis. 2020 Aug;29(8):104958. doi: 10.1016/j.jstrokecerebrovasdis.2020.104958. Epub 2020 Jun 5.
Patients with intracerebral hemorrhage are susceptible to venous thromboembolism, but the relationship between venous thromboembolism and outcome is largely unknown. We aim to investigate the association of in-hospital venous thromboembolism with functional outcome in patients with intracerebral hemorrhage.
From September 2014 through August 2016, we conducted a hospital-based, prospective study by consecutively recruiting eligible patients with first-ever acute spontaneous intracerebral hemorrhage. In-hospital venous thromboembolism was defined as observation of pulmonary embolism or deep vein thrombosis during initial hospitalization. The primary end point was death or disability (modified Rankin Scale 3 to 6) at discharge, 3-month and 1-year follow-up. Logistic analysis was conducted to evaluate the association of venous thromboembolism and poor functional outcome.
Among 637 participants included in the analysis, the prevalence of venous thromboembolism was 22.6%. After adjusting for confounding factors, venous thromboembolism was independently associated with death or disability at discharge (odds ratio 2.09, 95% confidence interval 1.12-3.85), 3-month follow-up (2.00 [1.12-3.54]) and 1-year follow-up (2.00 [1.14-3.49]). Venous thromboembolism was also an independent indicator of disability (modified Rankin Scale 3-5) among ICH survivors, with odds ratios ranging from 1.93 to 2.08 (all P<0.05). The relationship was stronger in patients with hematoma volume <10 ml (3.24 [1.11-9.46]) and ≥30 ml (2.57 [1.03-6.44]) (P for interaction=0.002) at 1-year follow-up. The results were confirmed by sensitivity analysis.
In-hospital venous thromboembolism was independently associated with poor outcome at discharge, 3-month and 1-year in patients with intracerebral hemorrhage.
脑出血患者易发生静脉血栓栓塞，但静脉血栓栓塞与结局的关系尚不清楚。我们旨在研究脑出血患者住院期间静脉血栓栓塞与功能结局的关系。
本研究为 2014 年 9 月至 2016 年 8 月进行的一项基于医院的前瞻性研究，连续招募了首次急性自发性脑出血的合格患者。住院期间静脉血栓栓塞定义为住院期间观察到肺栓塞或深静脉血栓形成。主要终点是出院、3 个月和 1 年随访时的死亡或残疾（改良 Rankin 量表 3-6 分）。采用 logistic 分析评估静脉血栓栓塞与不良功能结局的关系。
在纳入分析的 637 名患者中，静脉血栓栓塞的患病率为 22.6%。在调整混杂因素后，静脉血栓栓塞与出院时的死亡或残疾（比值比 2.09，95%置信区间 1.12-3.85）、3 个月随访（2.00 [1.12-3.54]）和 1 年随访（2.00 [1.14-3.49]）独立相关。静脉血栓栓塞也是脑出血存活者残疾（改良 Rankin 量表 3-5 分）的独立指标，比值比为 1.93 至 2.08（均 P<0.05）。在血肿量<10ml（3.24 [1.11-9.46]）和≥30ml（2.57 [1.03-6.44]）的患者中，这种关系更强（P 交互=0.002）。敏感性分析结果证实了这一结果。
脑出血患者住院期间静脉血栓栓塞与出院时、3 个月和 1 年时的不良结局独立相关。
