Choi Hyun-Young, Cho Yongil, Kim Wonhee, Minn Yang-Ki, Kang Gu-Hyun, Jang Yong-Soo, Lee Yoonje, Kim Jae-Guk, Kim Jihoon, Cho Youngsuk, Shin Hyungoo, Moon Shinje, Ahn Chiwon, Lee Juncheol, Shin Dong-Geum, Park Jae-Keun
Department of Emergency Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Korea.
Hallym Biomedical Informatics Convergence Research Center, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Korea.
J Pers Med. 2022 Jul 30;12(8):1260. doi: 10.3390/jpm12081260.
This study investigated the impact of intracerebral hemorrhage (ICH) on the cumulative mortality of patients with hyperacute ischemic stroke. This population-based retrospective cohort study used claims data from the National Health Insurance Service customized database of South Korea. The recruitment period was 2005−2018. The study population included patients with hyperacute ischemic stroke who had received intravenous thrombolysis. The primary endpoint was 12-month cumulative mortality, which was analyzed in both the ICH and no-ICH groups. Of the 50,550 patients included, 2567 (5.1%) and 47,983 (94.9%) belonged to the ICH and no-ICH groups, respectively. In the univariable analysis for 12-month mortality, ICH patients were substantially more prevalent among dead patients than among patients who survived (11.6% versus 3.6%; p < 0.001). The overall 12-month cumulative mortality rate was 18.8%. Mortality in the ICH group was higher than that in the no-ICH group (42.8% versus 17.5%; p < 0.001). In the multivariable analysis, the risk of 12-month cumulative mortality was 2.97 times higher in the ICH group than in the no-ICH group (95% confidence interval, 2.79−3.16). The risk of 12-month cumulative mortality in hyperacute ischemic stroke can increase approximately threefold after the occurrence of spontaneous ICH following intravenous thrombolysis.
本研究调查了脑出血（ICH）对超急性缺血性卒中患者累积死亡率的影响。这项基于人群的回顾性队列研究使用了韩国国民健康保险服务定制数据库中的理赔数据。招募期为2005 - 2018年。研究人群包括接受静脉溶栓治疗的超急性缺血性卒中患者。主要终点是12个月累积死亡率，在脑出血组和无脑出血组中均进行了分析。纳入的50550例患者中，分别有2567例（5.1%）和47983例（94.9%）属于脑出血组和无脑出血组。在对12个月死亡率的单变量分析中，脑出血患者在死亡患者中的比例显著高于存活患者（11.6%对3.6%；p < 0.001）。总体12个月累积死亡率为18.8%。脑出血组的死亡率高于无脑出血组（42.8%对17.5%；p < 0.001）。在多变量分析中，脑出血组12个月累积死亡风险比无脑出血组高2.97倍（95%置信区间，2.79 - 3.16）。静脉溶栓后发生自发性脑出血后，超急性缺血性卒中12个月累积死亡风险可增加约三倍。
