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形态不规则可作为预测原发性脑出血患者预后的独立指标。

Irregular shape as an independent predictor of prognosis in patients with primary intracerebral hemorrhage.

机构信息

Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Youzheng Street 23, Nangang District, Harbin, 150001, Heilongjiang Province, China.

Institute of Brain Science, Harbin Medical University, Harbin, China.

出版信息

Sci Rep. 2022 May 20;12(1):8552. doi: 10.1038/s41598-022-12536-3.

Abstract

The utility of noncontrast computed tomography markers in the prognosis of spontaneous intracerebral hemorrhage has been studied. This study aimed to investigate the predictive value of the computed tomography (CT) irregularity shape for poor functional outcomes in patients with spontaneous intracerebral hemorrhage. We retrospectively reviewed all 782 patients with intracranial hemorrhage in our stroke emergency center from January 2018 to September 2019. Laboratory examination and CT examination were performed within 24 h of admission. After three months, the patient's functional outcome was assessed using the modified Rankin Scale. Multinomial logistic regression analyses were applied to identify independent predictors of functional outcome in patients with intracerebral hemorrhage. Out of the 627 patients included in this study, those with irregular shapes on CT imaging had a higher proportion of poor outcomes and mortality 90 days after discharge (P < 0.001). Irregular shapes were found to be significant independent predictors of poor outcome and mortality on multiple logistic regression analysis. In addition, the increase in plasma D-dimer was associated with the occurrence of irregular shapes (P = 0.0387). Patients with irregular shapes showed worse functional outcomes after intracerebral hemorrhage. The elevated expression level of plasma D-dimers may be directly related to the formation of irregular shapes.

摘要

已经研究了非对比计算机断层扫描标志物在自发性脑出血预后中的作用。本研究旨在探讨 CT 不规则形状对自发性脑出血患者不良功能结局的预测价值。我们回顾性分析了 2018 年 1 月至 2019 年 9 月在我们卒中急救中心的所有 782 名颅内出血患者。入院后 24 小时内进行实验室检查和 CT 检查。三个月后,采用改良 Rankin 量表评估患者的功能结局。应用多项逻辑回归分析识别脑出血患者功能结局的独立预测因素。在这项研究中,627 名患者中,CT 图像不规则形状的患者出院后 90 天的不良结局和死亡率比例更高(P<0.001)。多项逻辑回归分析显示,不规则形状是不良结局和死亡率的显著独立预测因素。此外,血浆 D-二聚体的升高与不规则形状的发生有关(P=0.0387)。脑出血后,形状不规则的患者功能结局较差。血浆 D-二聚体的表达水平升高可能与不规则形状的形成直接相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4276/9123162/fce9a8f12c34/41598_2022_12536_Fig1_HTML.jpg

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