Chen Shijian, Zhang Jian, Lu Xianfu, Cen Gengyu, Song Yiting, Deng Xuhui, Xie Yiju, Liu Liuyu, Liu Qianqian, Huang Junling, Li Jing, Yang Hong, Shi Shengliang, Pan Liya, Liang Zhijian
Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Department of Neurology, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China.
Front Cell Neurosci. 2022 Feb 7;16:813084. doi: 10.3389/fncel.2022.813084. eCollection 2022.
To investigate the clinical features, risk factors and underlying pathogenesis of cancer related subarachnoid hemorrhage (SAH).
Clinical data of SAH in patients with active cancer from January 2010 to December 2020 at four centers were retrospectively reviewed. Patients with active cancer without SAH were matched to SAH patients with active cancer group. Logistic regression was applied to investigate the independent risk factors of SAH in patients with active cancer, after a 1:1 propensity score matching (PSM). A receiver operator characteristic curve was configured to calculate the optimal cut-off value of the joint predictive factor for cancer related SAH.
A total of 82 SAH patients with active cancer and 309 patients with active cancer alone were included. Most SAH patients with cancer had poor outcomes, with 30-day mortality of 41.5%, and with 90-day mortality of 52.0%. The PSM yielded 75 pairs of study participants. Logistic regression revealed that a decrease in platelet and prolonged prothrombin time were the independent risk factors of cancer related SAH. In addition, receiver operator characteristic curve of the joint predictive factor showed the largest AUC of 0.8131, with cut-off value equaling to 11.719, with a sensitivity of 65.3% and specificity of 89.3%.
Patients with cancer related SAH often have poor outcomes. The decrease in platelet and prolonged prothrombin time are the independent risk factors of cancer related SAH, and the joint predictive factor with cutoff value equal to 11.719 should hence serve as a novel biomarker of cancer related SAH.
探讨癌症相关性蛛网膜下腔出血（SAH）的临床特征、危险因素及潜在发病机制。
回顾性分析2010年1月至2020年12月四个中心活动性癌症患者SAH的临床资料。将无SAH的活动性癌症患者与活动性癌症伴SAH患者进行匹配。在1:1倾向评分匹配（PSM）后，应用逻辑回归分析活动性癌症患者SAH的独立危险因素。绘制受试者工作特征曲线，计算癌症相关性SAH联合预测因子的最佳截断值。
共纳入82例活动性癌症伴SAH患者和309例单纯活动性癌症患者。大多数癌症相关性SAH患者预后较差，30天死亡率为41.5%，90天死亡率为52.0%。PSM产生75对研究对象。逻辑回归显示血小板减少和凝血酶原时间延长是癌症相关性SAH的独立危险因素。此外，联合预测因子的受试者工作特征曲线显示最大曲线下面积（AUC）为0.8131，截断值为11.719，敏感性为65.3%，特异性为89.3%。
癌症相关性SAH患者预后往往较差。血小板减少和凝血酶原时间延长是癌症相关性SAH的独立危险因素，截断值为11.719的联合预测因子应作为癌症相关性SAH的新型生物标志物。
