Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Neurological Center, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China.
Clin Neurol Neurosurg. 2023 Apr;227:107640. doi: 10.1016/j.clineuro.2023.107640. Epub 2023 Feb 25.
Some peripheral blood markers have been demonstrated to be correlated with the re-formation of chronic subdural hematoma (CSDH). The aim of this study was to identify the correlation between nutritional/inflammatory peripheral blood markers and CSDH.
188 CSDH patients and 188 age-matched healthy controls were included in this research. The clinical characteristics and peripheral blood markers associated with nutritional or inflammatory status were obtained and analyzed. Conditional logistic regression analysis was applied to identify the potential CSDH risk factors. All the participants were divided into 3 groups based on the tertiles of change in risk factors. The Cochran-Armitage test and one way ANOVA were applied to identify the association between baseline characteristics and independent risk factors. Moreover, the net reclassification index (NRI) and integrated discrimination index (IDI) were calculated to evaluate the improvement in model performance after adding the independent risk factors in the conventional model.
The logistic regression analysis demonstrated that the increased albumin (OR, 0.615; 95 %CI,0.489-0.773; P < 0.001) and lymphocyte count (OR, 0.141; 95 %CI,0.025-0.796; P = 0.027) were associated with lower risk of CSDH. Moreover, addition of albumin and lymphocyte to conventional risk factors significantly improved the risk prediction of CSDH(NRI: 46.47 %, P < 0.001; IDI: 30.92 %, P < 0.001; NRI: 22.45 %, P = 0.027; IDI: 1.23 %, P = 0.037, respectively) CONCLUSION: The decreased albumin and lymphocyte levels were correlated with a high risk of chronic subdural hematoma. The nutritional and inflammatory serum markers should be put great attention because these markers may play roles in finding the cause of CSDH and predicting its risk.
一些外周血标志物已被证明与慢性硬脑膜下血肿（CSDH）的再形成相关。本研究旨在确定营养/炎症相关外周血标志物与 CSDH 之间的相关性。
本研究纳入了 188 例 CSDH 患者和 188 名年龄匹配的健康对照者。收集并分析了与营养或炎症状态相关的临床特征和外周血标志物。应用条件 logistic 回归分析确定潜在的 CSDH 危险因素。所有参与者根据危险因素变化的三分位数分为 3 组。应用 Cochran-Armitage 检验和单因素方差分析，以确定基线特征与独立危险因素之间的关系。此外，计算净重新分类指数（NRI）和综合判别指数（IDI），以评估在常规模型中加入独立危险因素后模型性能的改善。
logistic 回归分析表明，白蛋白升高（OR，0.615；95%CI，0.489-0.773；P<0.001）和淋巴细胞计数降低（OR，0.141；95%CI，0.025-0.796；P=0.027）与 CSDH 风险降低相关。此外，白蛋白和淋巴细胞的加入可显著提高 CSDH 的风险预测（NRI：46.47%，P<0.001；IDI：30.92%，P<0.001；NRI：22.45%，P=0.027；IDI：1.23%，P=0.037）。
白蛋白和淋巴细胞水平降低与慢性硬脑膜下血肿的高风险相关。营养和炎症血清标志物应引起重视，因为这些标志物可能在寻找 CSDH 的病因和预测其风险方面发挥作用。
