Wang Yanglingxi, Chen Peng, Liang Yidan, Deng Yongbing, Zhou Weiduo
Department of Neurosurgery, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing University, Chongqing, China.
Front Neurol. 2024 Jun 4;15:1337168. doi: 10.3389/fneur.2024.1337168. eCollection 2024.
This study aimed to explore the correlation between serum potassium (K) concentration upon admission and the presence of the Island Sign (IS) in cranial CT scans of patients diagnosed with Hypertensive Intracerebral Hemorrhage (HICH), including the potential presence of a non-linear relationship.
This investigation constituted a single-center cross-sectional study. We systematically gathered comprehensive general clinical characteristics, biological indicators, and imaging data from a cohort of 330 patients diagnosed with HICH. These patients received treatment within the neurosurgery department of Chongqing Emergency Medical Center during the period spanning from July 1, 2018, to July 7, 2023. Our primary objective was to scrutinize the potential connection between serum K concentration upon admission and the presence of the IS observed in cranial CT scans. To meticulously address this inquiry, we employed logistic regression modeling, thereby meticulously evaluating the correlation aforementioned. Moreover, in order to delve deeper into the intricacies of the relationship, we extended our analysis by employing a smoothed curve-fitting model to meticulously authenticate the potential non-linear interrelation between these two critical variables.
In this investigation, a total of 330 patients diagnosed with HICH were ultimately enrolled, exhibiting an average age of 58.4 ± 13.1 years, comprising 238 (72.1%) males and 92 (27.9%) females. Among these participants, 118 individuals (35.7%) presented with the IS upon admission cranial CT scans, while 212 patients (64.3%) did not exhibit this characteristic. Upon comprehensive multifactorial adjustments, a non-linear association was uncovered between serum K concentration and the presence of IS. Notably, an inflection point was identified at approximately 3.54 mmol/L for serum K concentration. Prior to the patient's serum K concentration reaching around 3.54 mmol/L upon admission, a discernible trend was observed-every 0.1 mmol/L increment in serum K concentration was associated with an 8% decrease in the incidence of IS (OR: 0.914, 95% CI: 0.849-0.983, = 0.015).
The findings of this study underscore a negative association between reduced serum K concentration upon admission and the occurrence of the IS on cranial CT scans among patients diagnosed with hypertensive cerebral hemorrhage. Furthermore, this negative correlation appears to manifest within the realm of a non-linear relationship. This study elucidates the potential significance of serum K concentration levels among patients with HICH, highlighting the role they play. Moreover, the maintenance of a physiological equilibrium in serum K concentrations emerges as a conceivable protective factor for individuals within the stroke population.
本研究旨在探讨高血压性脑出血（HICH）患者入院时血清钾（K）浓度与头颅CT扫描中岛征（IS）的相关性，包括潜在的非线性关系。
本调查为单中心横断面研究。我们系统收集了330例诊断为HICH患者的综合一般临床特征、生物学指标和影像学数据。这些患者于2018年7月1日至2023年7月7日在重庆急救医疗中心神经外科接受治疗。我们的主要目的是仔细研究入院时血清钾浓度与头颅CT扫描中观察到的岛征之间的潜在联系。为了严谨地解决这个问题，我们采用逻辑回归模型，从而仔细评估上述相关性。此外，为了更深入地探究这种关系的复杂性，我们通过使用平滑曲线拟合模型扩展了分析，以仔细验证这两个关键变量之间潜在的非线性相互关系。
在本调查中，最终纳入了330例诊断为HICH的患者，平均年龄为58.4±13.1岁，其中男性238例（72.1%），女性92例（27.9%）。在这些参与者中，118人（35.7%）在入院头颅CT扫描时出现岛征，而212例患者（64.3%）未表现出该特征。经过全面的多因素调整后，发现血清钾浓度与岛征的存在之间存在非线性关联。值得注意的是，血清钾浓度在约3.54 mmol/L处确定了一个拐点。在患者入院时血清钾浓度达到约3.54 mmol/L之前，观察到一个明显的趋势——血清钾浓度每增加0.1 mmol/L，岛征的发生率就会降低8%（OR：0.914，95%CI：0.849 - 0.983，P = 0.015）。
本研究结果强调了入院时血清钾浓度降低与高血压性脑出血患者头颅CT扫描中岛征的发生之间存在负相关。此外，这种负相关似乎在非线性关系范围内表现出来。本研究阐明了血清钾浓度水平在HICH患者中的潜在意义，突出了它们所起的作用。此外，维持血清钾浓度的生理平衡似乎是卒中人群中个体的一个可想象的保护因素。
