国家神经系统疾病临床医学研究中心数据管理与共享系统
Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Predictors and Clinical Impact of Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage: Analysis from China National Stroke Registry
第一作者：Wanying Duan
通讯作者：Liping Liu
基本信息
- 负责人：Wanying Duan
- 数据来源： CNSR-I
- 论文编号：CNSR-I20190235
- 发表时间：2017-10-19
2017-10-19
已发表文章
发表杂志：CEREBROVASCULAR DISEASES
发表类型: Original Contributions
影响因子(IF): 2.762
PMID: 29049994 Pubmed原文链接 全文下载
主要研究背景及目的
Introduction Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) is a significant cause of morbidity and mortality, the pre- dictive value of potential early factors is uncertain. This study aimed to identify independent predictors of DCI and clarify its clinical impact on patients’ outcome and disease course.
方法
This was a nationwide, prospective cohort study involving consecutive patients with aSAH recruited from the China National Stroke Registry. Univariate and multivariate lo- gistic regression were performed to identify predictors of DCI and evaluate the contribution of DCI to short- and long-term outcomes.
结论
The occurrence of DCI after aSAH was independently predicted by sex, history of diabetes mellitus and poor clinical grade. DCI was associated with severe clinical course, poor outcome, and mortality both in short- and long-term of aSAH pa- tients in China.
主要结果
The study included 504 patients with aSAH and 155 of them (30.8%) developed DCI. Among factors on admission, female (OR: 1.57; 95% CI: 1.05 to 2.36, p = 0.029), History of diabetes mellitus (OR: 2.31; 95% CI: 1.09 to 4.89, p = 0.030), Hunt and Hess grade 4–5 (OR: 4.46; 95% CI: 1.74 to 9.74, p < 0.001) and WFNS grade IV-V (OR: 3.66; 95% CI: 1.91 to 7.02, p < 0.001) were independent predictors of DCI. Patients with DCI was associated with high in-hospital complications including pneumonia (p = 0.006), cardiac arrhythmias (p = 0.002), gastrointestinal hemorrhage (p < 0.001) and urinary tract infection (p = 0.004), as well as high supporting interventions utilized rate (p = 0.006). DCI also contributed to poorer functional outcome and higher mortality at 3-, 6-, and 12-month.