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脑出血后入院时脱水与显著降低的院内死亡率相关。

Admission Dehydration Is Associated With Significantly Lower In-Hospital Mortality After Intracerebral Hemorrhage.

作者信息

Gao Bin, Gu Hongqiu, Yu Wengui, Liu Shimeng, Zhou Qi, Kang Kaijiang, Zhang Jia, Li Zixiao, Zhao Xingquan, Wang Yongjun

机构信息

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

China National Clinical Research Center for Neurological Diseases, Beijing, China.

出版信息

Front Neurol. 2021 Mar 8;12:637001. doi: 10.3389/fneur.2021.637001. eCollection 2021.

Abstract

Our aim was to investigate the frequency of dehydration at admission and associations with in-hospital mortality in patients with intracerebral hemorrhage (ICH). Data of consecutive patients with ICH between August 2015 and July 2019 from the China Stroke Center Alliance (CSCA) registry were analyzed. The patients were stratified based on the blood urea nitrogen (BUN) to creatinine (CR) ratio (BUN/CR) on admission into dehydrated (BUN/CR ≥ 15) or non-dehydrated (BUN/CR < 15) groups. Data were analyzed with multivariate logistic regression models to investigate admission dehydration status and the risks of death at hospital. A total number of 84,043 patients with ICH were included in the study. The median age of patients on admission was 63.0 years, and 37.5% of them were women. Based on the baseline BUN/CR, 59,153 (70.4%) patients were classified into dehydration group. Patients with admission dehydration (BUN/CR ≥ 15) had 13% lower risks of in-hospital mortality than those without dehydration (BUN/CR < 15, adjusted OR = 0.87, 95%CI 0.78-0.96). In patients aged <65 years, admission dehydration was associated with 19% lower risks of in-hospital mortality (adjusted OR = 0.81, 95%CI 0.70-0.94. adjusted = 0.0049) than non-dehydrated patients. Admission dehydration is associated with significantly lower in-hospital mortality after ICH, in particular, in patients <65 years old.

摘要

我们的目的是调查脑出血(ICH)患者入院时脱水的发生率及其与院内死亡率的相关性。分析了中国卒中中心联盟(CSCA)登记处2015年8月至2019年7月期间连续的ICH患者数据。根据入院时血尿素氮(BUN)与肌酐(CR)的比值(BUN/CR),将患者分为脱水组(BUN/CR≥15)和非脱水组(BUN/CR<15)。采用多因素logistic回归模型分析数据,以研究入院时的脱水状态和医院死亡风险。本研究共纳入84043例ICH患者。患者入院时的中位年龄为63.0岁,其中37.5%为女性。根据基线BUN/CR,59153例(70.4%)患者被分类为脱水组。入院时脱水的患者(BUN/CR≥15)的院内死亡风险比未脱水的患者低13%(校正OR=0.87,95%CI 0.78-0.96)。在年龄<65岁的患者中,入院时脱水与院内死亡风险降低19%相关(校正OR=0.81,95%CI 0.70-0.94,校正P=0.0049)。入院时脱水与ICH后显著降低的院内死亡率相关,尤其是在<65岁的患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84c1/7982572/610b2fbe2571/fneur-12-637001-g0001.jpg

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