Shen Zhiyuan, Jin Haiqiang, Lu Yuxuan, Sun Wei, Liu Ran, Li Fan, Shu Junlong, Tai Liwen, Li Guozhong, Chen Huisheng, Zhang Guiru, Zhang Lei, Sun Xuwen, Qiu Jinhua, Wei Yan, Sun Weiping, Huang Yining
Department of Neurology, Peking University First Hospital, Beijing, China.
Department of Neurology, Second Hospital of Hebei Medical University, Shijiazhuang, China.
Front Neurol. 2021 Sep 28;12:727304. doi: 10.3389/fneur.2021.727304. eCollection 2021.
There is limited information on symptomatic intracranial hemorrhage (sICH) in stroke patients without thrombolysis. This study aimed to evaluate the risk factors of sICH and the association between sICH and the prognosis at 3 and 12 months in acute ischemic stroke patients without thrombolysis. Data originated from the Chinese Acute Ischemic Stroke Treatment Outcome Registry. Univariate analysis and multivariate logistic regression were used to screen the risk factors of sICH. Multivariable logistic regression models were used to assess the association of sICH with poor outcome and all-cause mortality. Totally, 9,484 patients were included, of which 69 (0.73%) had sICH. Atrial fibrillation (odds ratio [OR], 3.682; 95% confidence interval [CI], 1.945-6.971; < 0.001), history of tumors (OR, 2.956; 95% CI, 1.115-7.593; = 0.024), and the National Institutes of Health Stroke Scale (NIHSS) score on admission ([6-15: OR, 2.344; 95% CI, 1.365-4.024; = 0.002] [>15: OR, 4.731; 95% CI, 1.648-13.583; = 0.004]) were independently associated with sICH. After adjustment of the confounders, patients with sICH had a higher risk of poor outcome (OR, 1.983; 95% CI, 1.117-3.521; = 0.018) at 3 months and that of all-cause mortality at 3 (OR, 6.135; 95% CI, 2.328-16.169; < 0.001) and 12 months (OR, 3.720; 95% CI, 1.513-9.148; = 0.004). sICH occurred in 0.73% of acute ischemic stroke patients without thrombolysis and was associated with a worse prognosis at 3 and 12 months. Atrial fibrillation, history of tumors, and NIHSS score at admission were independent risk factors of sICH.
关于未接受溶栓治疗的中风患者出现症状性颅内出血（sICH）的信息有限。本研究旨在评估sICH的危险因素以及未接受溶栓治疗的急性缺血性中风患者在3个月和12个月时sICH与预后之间的关联。数据源自中国急性缺血性中风治疗结果登记处。采用单因素分析和多因素逻辑回归来筛选sICH的危险因素。使用多变量逻辑回归模型评估sICH与不良预后和全因死亡率之间的关联。总共纳入了9484例患者，其中69例（0.73%）发生了sICH。心房颤动（比值比[OR]，3.682；95%置信区间[CI]，1.945 - 6.971；P < 0.001）、肿瘤病史（OR，2.956；95% CI，1.115 - 7.593；P = 0.024）以及入院时的美国国立卫生研究院卒中量表（NIHSS）评分（[6 - 15分：OR，2.344；95% CI，1.365 - 4.024；P = 0.002] [>15分：OR，4.731；95% CI，1.648 - 13.583；P = 0.004]）与sICH独立相关。在对混杂因素进行调整后，发生sICH的患者在3个月时出现不良预后的风险更高（OR，1.983；95% CI，1.117 - 3.521；P = 0.018），在3个月（OR，6.135；95% CI，2.328 - 16.169；P < 0.001）和12个月（OR，3.720；95% CI，1.513 - 9.148；P = 0.004）时全因死亡率的风险更高。0.73%未接受溶栓治疗的急性缺血性中风患者发生了sICH，且与3个月和12个月时更差的预后相关。心房颤动、肿瘤病史和入院时的NIHSS评分是sICH的独立危险因素。
