Shen Jun, Shao Xuefei, Ge Ruixiang, Di Guangfu, Jiang Xiaochun
Department of Neurosurgery, The First Affiliated Hospital (YiJiShan Hospital) of Wannan Medical College, Wuhu City, Anhui, 241001, People's Republic of China.
Risk Manag Healthc Policy. 2021 May 18;14:2045-2053. doi: 10.2147/RMHP.S309286. eCollection 2021.
Postoperative rebleeding (PRB) is one of the most severe complications after hematoma evacuation of spontaneous intracerebral hemorrhage (ICH). PRB has been proven to be an independent risk factor for poor prognosis. Previous studies have shown that spot sign and blend sign are independent risk factors for PRB of spontaneous ICH. However, the risk factors for PRB of spontaneous cerebellar hemorrhage (SCH) have not been elucidated. The aim of the present study was to investigate the possible risk factors for PRB and short-term prognosis of patients with SCH.
This study identified 62 patients with SCH who underwent hematoma evacuation in our department. Risk factors for PRB and short-term prognosis were identified by a univariable logistic regression model, and predictors with a value of less than 0.05 were included in the multivariable logistic regression model to identify independent predictors. A receiver operating characteristic (ROC) curve was created to test the sensitivity and specificity of independent risk factors.
Hematoma volume was the only independent predictor of PRB (OR=15.14, 95% CI=1.08-213.1, =0.044). The sensitivity and specificity of hematoma volume to PRB were 63.6% and 89.7%, respectively, and the cutoff value of hematoma volume was >29.3 mL. GCS score ≤8 (OR=5.131, 95% CI=1.030-25.554, =0.046) and PRB (OR=13.17, 95% CI=1.316-131.798, =0.028) were independent risk factors for poor prognosis of patients with SCH. The sensitivity and specificity of the GCS score to poor prognosis were 66.7% and 86.2%, respectively. The sensitivity and specificity of the PRB to poor prognosis were 36.4% and 96.6%, respectively.
Hematoma volume is likely to be a strong predictor of PRB among patients with SCH. GCS scores ≤8 on arrival and PRB were significant predictors of short-term poor outcome.
术后再出血（PRB）是自发性脑出血（ICH）血肿清除术后最严重的并发症之一。PRB已被证明是预后不良的独立危险因素。既往研究表明，斑点征和混合征是自发性ICH患者PRB的独立危险因素。然而，自发性小脑出血（SCH）患者PRB的危险因素尚未阐明。本研究的目的是探讨SCH患者PRB的可能危险因素及短期预后。
本研究纳入了62例在我科接受血肿清除术的SCH患者。通过单因素逻辑回归模型确定PRB和短期预后的危险因素，并将P值小于0.05的预测因素纳入多因素逻辑回归模型以确定独立预测因素。绘制受试者工作特征（ROC）曲线以检验独立危险因素的敏感性和特异性。
血肿体积是PRB的唯一独立预测因素（OR=15.14，95%CI=1.08-213.1，P=0.044）。血肿体积对PRB的敏感性和特异性分别为63.6%和89.7%，血肿体积的截断值>29.3 mL。格拉斯哥昏迷量表（GCS）评分≤8（OR=5.131，95%CI=1.030-25.554，P=0.046）和PRB（OR=13.17，95%CI=1.316-131.798，P=0.028）是SCH患者预后不良的独立危险因素。GCS评分对预后不良的敏感性和特异性分别为66.7%和86.2%。PRB对预后不良的敏感性和特异性分别为36.4%和96.6%。
血肿体积可能是SCH患者PRB的有力预测因素。入院时GCS评分≤8和PRB是短期预后不良的重要预测因素。
