肾功能与脑出血患者的一个月和一年死亡率相关。
Renal function is associated with one-month and one-year mortality in patients with intracerebral hemorrhage.
机构信息
Department of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
Division of Nephrology, China Medical University Hospital, Taichung, Taiwan.
出版信息
PLoS One. 2023 Jan 26;18(1):e0269096. doi: 10.1371/journal.pone.0269096. eCollection 2023.
OBJECTIVE
This study evaluated short-term (1-month) and long-term (1-year) mortality risks associated with the glomerular filtration rate (eGFR) on admission for patients with intracerebral hemorrhage.
METHODS
From the Taiwan Stroke Registry data from April 2006 to December 2016, we identified and stratified patients with intracerebral hemorrhage into five subgroups by the eGFR level on admission: ≥90, 60-89, 30-59, 15-29, and <15 mL/min/1.73 m2 or on dialysis. Risks for 1-month and 1-year mortality after intracerebral hemorrhage were compared by the eGFR levels.
RESULTS
Both the 1-month and 1-year mortality rates progressively increased with the decrease in eGFR levels. The 1-month mortality rate in patients with eGFR < 15 mL/min/1.73 m2 or on dialysis was approximately 5.5-fold greater than that in patients with eGFR ≥ 90 mL/min/1.73 m2 (8.31 versus 1.50 per 1000 person-days), with an adjusted hazard ratio (HR) of 4.59 [95% confidence interval (CI) = 2.71-7.78]. Similarly, the 1-year mortality in patients with eGFR < 15 mL/min/1.73 m2 or on dialysis was 7.5 times that in patients with eGFR ≥ 90 mL/min/1.73 m2 (2.34 versus 0.31 per 1000 person-days), with an adjusted HR of 4.54 (95% CI 2.95-6.98).
CONCLUSION
Impairment of renal function is an independent risk factor for mortality in patients with intracerebral hemorrhage in a gradual way. The eGFR level is a prognostic indicator for patients with intracerebral hemorrhage.
目的
本研究评估了入院时肾小球滤过率（eGFR）与脑出血患者短期（1 个月）和长期（1 年）死亡率的相关性。
方法
我们从 2006 年 4 月至 2016 年 12 月的台湾脑卒中注册数据中，根据入院时的 eGFR 水平将脑出血患者分为 5 个亚组：≥90、60-89、30-59、15-29 和 <15 mL/min/1.73 m2 或透析。通过 eGFR 水平比较脑出血后 1 个月和 1 年死亡率的风险。
结果
随着 eGFR 水平的降低，1 个月和 1 年死亡率均逐渐升高。eGFR < 15 mL/min/1.73 m2 或透析的患者 1 个月死亡率约为 eGFR ≥ 90 mL/min/1.73 m2 的患者的 5.5 倍（8.31 比 1.50/1000 人天），调整后的危险比（HR）为 4.59（95%置信区间 [CI] = 2.71-7.78）。同样，eGFR < 15 mL/min/1.73 m2 或透析的患者 1 年死亡率是 eGFR ≥ 90 mL/min/1.73 m2 的患者的 7.5 倍（2.34 比 0.31/1000 人天），调整后的 HR 为 4.54（95%CI 2.95-6.98）。
结论
肾功能损害是脑出血患者死亡率的一个独立危险因素，呈渐进式。eGFR 水平是脑出血患者的预后指标。
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