Correlation of leukocytosis with early neurological deterioration following supratentorial intracerebral hemorrhage.
Correlation of leukocytosis with early neurological deterioration following supratentorial intracerebral hemorrhage.
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DOI：
10.1016/j.jocn.2011.11.020
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发表时间：
2012-08
影响因子：
2
通讯作者：
James, Michael L.
中科院分区：
文献类型：
--
作者：
Sun, Wei;Peacock, Amanda;Becker, Jane;Phillips-Bute, Barbara;Laskowitz, Daniel T.;James, Michael L.
脑出血是美国重症监护病房常见的致命疾病。尽管重症监护取得了进展，但由于各种因素（包括血肿和脑水肿演变），ICH患者通常在入院后的前72小时内发生早期神经功能恶化（END）。本研究的目的是确定与脑出血后END相关的因素。使用杜克大学医院神经科学重症监护室数据库，我们回顾性识别了2010年1月至12月收治的幕上ICH患者，并通过CT成像进行了验证。END定义为出血后前72小时内格拉斯哥昏迷量表评分降低≥ 3分或死亡。适当时，使用卡方或t检验分析比较各组。进行多元逻辑回归模型以检验END的可能预测因素之间的关联。在89例幕上ICH患者中，我们基于完整数据集将83例纳入分析。其中，31人在症状发作后72小时内经历了END。ICH评分、影像学中线移位和白色血细胞（WBC）计数用于预测END的回归模型。白细胞计数与END的相关性最大。ICH患者在出血后的最初几天内容易发生END。WBC计数升高似乎预示恶化。这些数据表明，ICH后炎症状态升高可能与损伤后早期恶化有关。
Intracerebral hemorrhage (ICH) is a devastating and common admitting diagnosis to intensive care units in the USA. Despite advances in critical care, patients with ICH often experience early neurological deterioration (END) in the first 72 hours after admission due to a variety of factors, including hematoma and cerebral edema evolution. The purpose of this study was to determine factors associated with END after ICH. Using the Duke University Hospital Neuroscience Critical Care Unit Database, we retrospectively identified patients with an admitting diagnosis of supratentorial ICH from January to December 2010, verified by CT imaging. END was defined as a decrease in the Glasgow Coma Scale score of ≥ 3 or death within the first 72 hours after hemorrhage. The chi-squared or t-test analysis was used to compare the groups, as appropriate. Multiple logistical regression modeling was performed to test for associations between likely predictors of END. Of the 89 subjects admitted with supratentorial ICH, we included 83 in the analysis based on complete datasets. Of these, 31 experienced END within 72 hours after onset of symptoms. ICH score, presence of midline shift on imaging, and white blood cell (WBC) count were used in a regression model for predicting END. WBC count demonstrated the greatest association with END. Patients with ICH are prone to END within the first few days after hemorrhage. Elevated WBC count appears predictive of deterioration. These data demonstrate that heightened inflammatory state after ICH may be related to early deterioration after injury.
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影响因子：
9.9
作者：
MAYER, SA;SACCO, RL;MOHR, JP
通讯作者：
MOHR, JP
影响因子：
8.3
作者：
Hemphill, JC;Bonovich, DC;Johnston, SC
通讯作者：
Johnston, SC
影响因子：
8.3
作者：
Rost, Natalia S.;Smith, Eric E.;Rosand, Jonathan
通讯作者：
Rosand, Jonathan
影响因子：
8.3
作者：
Ruiz-Sandoval, Jose L.;Chiquete, Erwin;Gonzalez-Cornejo, Salvador
通讯作者：
Gonzalez-Cornejo, Salvador
影响因子：
2.6
作者：
Chuang, Ya-Ching;Chen, Yung-Ming;Peng, Shih-Yen
通讯作者：
Peng, Shih-Yen