Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China.
Ann Clin Transl Neurol. 2024 Feb;11(2):368-376. doi: 10.1002/acn3.51957. Epub 2023 Nov 27.
To assess the prevalence and factors associated with early cognitive impairment in intracerebral hemorrhage (ICH) patients and to describe short-term recovery trajectories among ICH patients with early cognitive impairment.
We prospectively enrolled ICH patients without baseline dementia in our institutions. Cognitive function was assessed using mini-mental state examination (MMSE), and functional outcome was evaluated at discharge, 3, and 6 months after symptoms onset using the modified Rankin Scale (mRS). We used multinomial logistic regression models to investigate potential risk factors and generalized linear models to analyze the functional outcome data.
Out of 181 patients with ICH, 167 were included in the final analysis. Early cognitive impairment occurred in 60.48% of patients with ICH. Age (odds ratio [OR] per 1-year increase, 1.037; 95% confidence interval [CI], 1.003-1.071; p = 0.034), National Institutes of Health Stroke Scale (NIHSS) score (OR per 1-point increase, 1.146; 95% CI, 1.065-1.233; p < 0.001) and lobar ICH location (OR, 4.774; 95% CI, 1.810-12.593; p = 0.002) were associated with early cognitive impairment in ICH patients. Patients with ≥10 years of education were less likely to experience early cognitive impairment (OR, 0.323; 95% CI, 0.133-0.783; p = 0.012). Participants with early cognitive impairment had a higher risk of poor outcome (OR, 4.315; 95% CI, 1.503-12.393; p = 0.005) than those without. Furthermore, there was a significantly faster functional recovery rate for those without early cognitive impairment compared with those with at 3 and 6 months (p < 0.05).
Early cognitive impairment was prevalent and associated with poor outcomes in ICH patients, which decelerated short-term functional recovery.
评估脑出血（ICH）患者早期认知障碍的发生率和相关因素，并描述早期认知障碍 ICH 患者的短期恢复轨迹。
我们前瞻性地纳入了我院无基线痴呆的 ICH 患者。使用简易精神状态检查（MMSE）评估认知功能，采用改良 Rankin 量表（mRS）在症状出现后 3 个月和 6 个月评估功能结局。我们使用多项逻辑回归模型来研究潜在的危险因素，并用广义线性模型来分析功能结局数据。
在 181 例 ICH 患者中，167 例患者纳入最终分析。60.48%的 ICH 患者发生早期认知障碍。年龄（每增加 1 岁的优势比[OR]，1.037；95%置信区间[CI]，1.003-1.071；p=0.034）、美国国立卫生研究院卒中量表（NIHSS）评分（每增加 1 分的 OR，1.146；95%CI，1.065-1.233；p<0.001）和脑叶 ICH 部位（OR，4.774；95%CI，1.810-12.593；p=0.002）与 ICH 患者的早期认知障碍相关。受教育年限≥10 年的患者发生早期认知障碍的可能性较低（OR，0.323；95%CI，0.133-0.783；p=0.012）。有早期认知障碍的参与者预后不良的风险更高（OR，4.315；95%CI，1.503-12.393；p=0.005），与无早期认知障碍者相比。此外，与有早期认知障碍者相比，无早期认知障碍者在 3 个月和 6 个月时的功能恢复速度明显更快（p<0.05）。
ICH 患者早期认知障碍较为常见，与预后不良相关，且会减缓短期功能恢复。
