Liu Yao, Wei Cunsheng
Department of Neurology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, 211100, People's Republic of China.
Int J Gen Med. 2024 Oct 25;17:4929-4936. doi: 10.2147/IJGM.S493510. eCollection 2024.
To explore the relevant factors affecting the prognosis of subarachnoid hemorrhage.
284 patients with subarachnoid hemorrhage who were hospitalized in our hospital from January 1, 2022 to June 30, 2024 were selected and divided into a good prognosis group and a poor prognosis group according to the modified Rankin Scale (mRS) score. The general clinical data of the patients were also collected, and the independent risk factors affecting the poor prognosis of the patients were screened by univariate logistic regression analysis.
Patients with a favorable prognosis had a lower incidence rate of rebleeding (4.72% vs 17.65%; =0.001), electrolyte disturbances (21.46% vs 41.18%; <0.001), lower respiratory tract infection (5.58% vs 35.29%; <0.001), urinary tract infection (1.72% vs 15.69%; <0.001) and gastrointestinal infection (2.15% vs 11.76%; <0.001) than patients with an unfavorable prognosis. Therefore, coinfection is an independent risk factor for prognosis. After adjusting for covariates, logistic regression analysis identified the prognosis of subarachnoid hemorrhage was related to coinfections (adjusted odds ratio =2.057; 95% CI: 1.516~2.791; <0.001).
Coinfection is a very important independent risk factor affecting prognosis, and clinical care should focus on how to reduce coinfection during hospitalization in patients with subarachnoid hemorrhage and treat it aggressively to reduce mortality and disability and improve patient prognosis.
探讨影响蛛网膜下腔出血预后的相关因素。
选取2022年1月1日至2024年6月30日在我院住院的284例蛛网膜下腔出血患者,根据改良Rankin量表(mRS)评分分为预后良好组和预后不良组。收集患者的一般临床资料,采用单因素logistic回归分析筛选影响患者预后不良的独立危险因素。
预后良好的患者再出血发生率(4.72%对17.65%;P=0.001)、电解质紊乱发生率(21.46%对41.18%;P<0.001)、下呼吸道感染发生率(5.58%对35.29%;P<0.001)、尿路感染发生率(1.72%对15.69%;P<0.001)和胃肠道感染发生率(2.15%对11.76%;P<0.001)均低于预后不良的患者。因此,合并感染是预后的独立危险因素。在调整协变量后,logistic回归分析确定蛛网膜下腔出血的预后与合并感染有关(调整后的优势比=2.057;95%可信区间:1.516~2.791;P<0.001)。
合并感染是影响预后的非常重要的独立危险因素,临床护理应重点关注如何降低蛛网膜下腔出血患者住院期间的合并感染,并积极进行治疗,以降低死亡率和残疾率,改善患者预后。