Pereira Marta, Batista Rafael, Marreiros Ana, Nzwalo Hipolito
Medical Education Unit, Faculty of Medicine and Biomedical Sciences, Algarve University, Faro, Portugal.
Algarve Biomedical Center Research Institute, Algarve University Hospital Center, Faro, Portugal.
Brain Circ. 2023 Jun 30;9(2):94-98. doi: 10.4103/bc.bc_5_23. eCollection 2023 Apr-Jun.
The incidence of spontaneous intracerebral hemorrhage (SICH) is highest in very old elderlies (≥75 years). The increasing use of antithrombotic drugs is shifting the epidemiology of SICH towards predominance of lobar subtype, suggesting an incremented propensity of bleeding associated with underlying cerebral amyloid angiopathy. With population aging and antithrombotic use, a parallel raise of proportion of lobar SICH is occurring. Improvement of prognostication in this specific age group and SICH type is needed. Routine blood biomarkers can contribute to prediction of short-term mortality after SICH.
Our aim was to investigate the contribution of routine blood biomarkers for short-term mortality (30-days) in elderly patients with lobar SICH.
Retrospective analysis of consecutive 130 patients with ≥ 75 years and lobar SICH. The outcome was 30-day mortality. Logistic regression analysis was used to investigate whether admission routine biomarkers can be used as predictors.
The case fatality was 40.8%. Admission glycaemia level, neutrophil to lymphocyte ratio and mean platelet volume were significantly different between groups (p = 0.001, p = 0.024, p = 0.038, respectively). There was no significant difference in all other routine biomarkers. On multivariate analysis, admission higher mean BG level (odds ratio [OR]: 1.010, 95% confidence interval [CI]: 1.001-1.019, p = 0.026) and neutrophil to lymphocyte ratio (OR: 1.070, 95% CI: 1.008-1.136, p = 0.027) emerged as predictors.
In very old patients with lobar SICH, higher BG level and neutrophil to lymphocyte ratio are associated with increased risk of short-term death.
自发性脑出血（SICH）的发病率在高龄老年人（≥75岁）中最高。抗血栓药物使用的增加正使SICH的流行病学朝着脑叶型亚型占主导地位转变，这表明与潜在脑淀粉样血管病相关的出血倾向增加。随着人口老龄化和抗血栓药物的使用，脑叶型SICH的比例也在同步上升。需要改善这一特定年龄组和SICH类型的预后预测。常规血液生物标志物有助于预测SICH后的短期死亡率。
我们的目的是研究常规血液生物标志物对老年脑叶型SICH患者短期死亡率（30天）的影响。
对130例年龄≥75岁的连续性脑叶型SICH患者进行回顾性分析。观察指标为30天死亡率。采用逻辑回归分析来研究入院时的常规生物标志物是否可作为预测指标。
病死率为40.8%。两组间入院时血糖水平、中性粒细胞与淋巴细胞比值及平均血小板体积存在显著差异（分别为p = 0.001、p = 0.024、p = 0.038）。所有其他常规生物标志物无显著差异。多因素分析显示，入院时较高的平均血糖水平（比值比[OR]：1.010，95%置信区间[CI]：1.001 - 1.019，p = 0.026）和中性粒细胞与淋巴细胞比值（OR：1.070，95% CI：1.008 - 1.136，p = 0.027）是预测指标。
在高龄脑叶型SICH患者中，较高的血糖水平和中性粒细胞与淋巴细胞比值与短期死亡风险增加相关。
