Chen Chu, Xie Yanfang, Pu Mingjun, Deng Lan, Li Zuoqiao, Yang Tiannan, Yin Hao, Zhang Zhehao, Lv Xinni, Liu Xueyun, Cheng Jing, Li Qi
Department of Neurology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Neurology, Second Affiliated Hospital of Anhui Medical University, Anhui, China.
Front Aging Neurosci. 2023 Nov 3;15:1264124. doi: 10.3389/fnagi.2023.1264124. eCollection 2023.
Intracerebral hemorrhage (ICH) is a severe form of stroke that remains understudied in the young adults. We aimed to investigate the clinical presentation, and risk factors associated with ICH in this age group and compare them to older patients.
Our study included ICH patients admitted between March 2016 and December 2021 in the First Affiliated Hospital of Chongqing Medical University from our ongoing prospective cohort database. Demographic characteristics, etiology, risk factors, and clinical outcomes were compared between elderly and young patients. Furthermore, logistic regression analysis was employed to explore risk factors associated with the functional outcome at 3-months.
We selected 1,003 patients (mean age, 59.9 ±13.8 years old), 746 (74.4%) patients were aged >50 years. The logistic regression analysis showed young patients have a higher proportion of secondary ICH, higher white blood cell count and higher body mass index (BMI), but less diabetes mellitus. Of all patients, predictors of 3-month functional independence was first-ever ICH and age ≤50 years. The history of nephropathy and stroke, higher baseline NIHSS score, larger hematoma volume, and the presence of hydrocephalus were associated with poor outcomes. And the white blood cell count could significantly influence the prognosis among young ICH patients. Three-month functional outcome based on modified Rankin scale score was better in young patients than the elderly (OR, 1.232; 95% CI, 1.095-1.388; < 0.001).
The highest incidence of ICH occurs in the age groups of 50-59 and 60-69. ICH in young adults had higher white blood cell and BMI compared to the elderly, and differs in etiological distribution. The young patients also had similar short-term mortality but more favorable functional outcomes than the elderly. Furthermore, NIHSS score and larger hematoma volumes were associated with poor outcome in all patients.
脑出血（ICH）是一种严重的中风类型，在年轻人中仍未得到充分研究。我们旨在调查该年龄组中脑出血的临床表现和相关危险因素，并将其与老年患者进行比较。
我们的研究纳入了2016年3月至2021年12月期间重庆医科大学附属第一医院从我们正在进行的前瞻性队列数据库中收治的脑出血患者。比较了老年和年轻患者的人口统计学特征、病因、危险因素和临床结局。此外，采用逻辑回归分析来探讨与3个月时功能结局相关的危险因素。
我们选取了1003例患者（平均年龄59.9±13.8岁），其中746例（74.4%）患者年龄>50岁。逻辑回归分析显示，年轻患者继发性脑出血的比例更高，白细胞计数和体重指数（BMI）更高，但糖尿病患者较少。在所有患者中，3个月功能独立的预测因素是首次发生脑出血且年龄≤50岁。肾病和中风病史、较高的基线美国国立卫生研究院卒中量表（NIHSS）评分、较大的血肿体积以及脑积水的存在与不良结局相关。白细胞计数可显著影响年轻脑出血患者的预后。基于改良Rankin量表评分的3个月功能结局在年轻患者中优于老年患者（比值比，1.232；95%置信区间，1.095-1.388；P<0.001）。
脑出血的最高发病率发生在50-59岁和60-69岁年龄组。与老年人相比，年轻人脑出血的白细胞和BMI更高，病因分布也有所不同。年轻患者的短期死亡率相似，但功能结局比老年人更有利。此外，NIHSS评分和较大的血肿体积与所有患者的不良结局相关。
