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糖尿病与原发性脑出血幸存者的长期功能结局较差相关——一项前瞻性研究。

Diabetes mellitus is associated with worse long-term functional outcomes in primary intracerebral hemorrhage survivors - A prospective study.

机构信息

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Yunlin Branch, 579, Section 2, Yunlin Rd., Douliu City, Yunlin County, Taiwan.

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital., 7, Zhongshan S. Rd, Taipei, Taiwan.

出版信息

Clin Neurol Neurosurg. 2024 Oct;245:108502. doi: 10.1016/j.clineuro.2024.108502. Epub 2024 Aug 6.

Abstract

OBJECTIVE

Primary intracerebral hemorrhage (ICH) accounts for 85 % of ICH and is associated with high morbidity and mortality. Identification of prognostic factors is critical to its management. However, previous studies showed conflicting results in whether diabetes mellitus (DM) is associated with outcomes among ICH patients. The present study examined the association between DM and long-term functional outcomes prospectively after ICH.

DESIGN

This prospective study examined the functional outcomes in primary ICH patients. This study excluded patients who died before discharge and those with ICH related to aneurysm, arteriovenous malformation, or trauma. Patients were followed up for 1 year after ICH. Functional outcome was based on the Barthel Index (BI). Severe dependency in ADL was defined by a BI of ≤60, and functional independence was defined by a BI of >90.

RESULTS

A total of 100 patients completed the 1-year follow-up, and 24 patients had DM. DM was significantly associated with worse functional outcomes 1 year post-ICH. The association remained significant after adjusting for baseline characteristics, comorbidities, and ICH score.

CONCLUSION

DM was an independent predictor of worse functional outcomes 1 year post-ICH. This study is the first to examine the effect of DM on long-term functional outcomes after ICH.

摘要

目的

原发性脑出血(ICH)占 ICH 的 85%,与高发病率和死亡率相关。确定预后因素对其治疗至关重要。然而,以前的研究表明,糖尿病(DM)是否与 ICH 患者的预后相关存在矛盾的结果。本研究前瞻性研究了 ICH 后 DM 与长期功能结局的关系。

设计

这项前瞻性研究检查了原发性 ICH 患者的功能结局。本研究排除了在出院前死亡的患者和因动脉瘤、动静脉畸形或创伤引起的 ICH 患者。ICH 后对患者进行为期 1 年的随访。功能结局基于 Barthel 指数(BI)。ADL 严重依赖定义为 BI≤60,功能独立定义为 BI>90。

结果

共有 100 名患者完成了 1 年的随访,其中 24 名患有 DM。DM 与 ICH 后 1 年的功能结局明显较差相关。在调整基线特征、合并症和 ICH 评分后,这种关联仍然显著。

结论

DM 是 ICH 后 1 年功能结局较差的独立预测因素。本研究首次检查了 DM 对 ICH 后长期功能结局的影响。

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