Hyperglycemia, Ischemic Lesions, and Functional Outcomes After Intracerebral Hemorrhage.
Hyperglycemia, Ischemic Lesions, and Functional Outcomes After Intracerebral Hemorrhage.
复制标题
脑出血后的高血糖、缺血性病变和功能预后
DOI：
10.1161/jaha.122.028632
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发表时间：
2023-07-04
影响因子：
5.4
通讯作者：
James, Michael L.
中科院分区：
文献类型：
--
作者：
Lusk, Jay B.;Covington, Anna;Liu, Li;Weikel, Daniel P.;Li, Yi-Ju;Sekar, Padmini;Demel, Stacie L.;Aziz, Yasmin N.;Kidwell, Chelsea S.;Woo, Daniel;James, Michael L.
关键词：
磁共振弥散加权成像（DWI）上观察到的缺血性病变与脑出血（ICH）后的不良结局相关。我们评估了高血糖、缺血性病变和脑出血后功能结局之间的关系。这是一项对ERICH（脑出血种族和人种差异）研究中接受磁共振成像的1167例患者进行的回顾性观察性分析。使用弹性网络正则化和选择程序的机器学习策略来执行自动变量选择，以识别最终的多变量逻辑回归模型。对替代模型开发策略进行了敏感性分析，并对预测性能进行了比较。协变量校正后，白色高信号评分、入院时白细胞计数和非西班牙裔黑人（与非西班牙裔白色人种相比）与DWI病变的存在相关。在协变量调整后，ICH和缺血性卒中病史、DWI病变的存在、深部ICH位置（相对于脑叶）、ICH体积、年龄、入院时较低的格拉斯哥昏迷评分和糖尿病病史与6个月改良兰金量表不良结局相关（4-6分）。纳入人种和种族之间的相互作用以及功能结局最终多变量模型中包含的变量改善了模型性能;观察到人种和种族与糖尿病病史和入院时血清血糖之间的显著相互作用。高血糖或糖尿病与DWI病变的存在无关。然而，糖尿病病史和DWI病变的存在与ICH后不良功能结局独立相关。
Ischemic lesions observed on diffusion‐weighted imaging (DWI) magnetic resonance imaging are associated with poor outcomes after intracerebral hemorrhage (ICH). We evaluated the association between hyperglycemia, ischemic lesions, and functional outcomes after ICH. This was a retrospective observational analysis of 1167 patients who received magnetic resonance imaging in the ERICH (Ethnic and Racial Variations in Intracerebral Hemorrhage) study. A machine learning strategy using the elastic net regularization and selection procedure was used to perform automated variable selection to identify final multivariable logistic regression models. Sensitivity analyses with alternative model development strategies were performed, and predictive performance was compared. After covariate adjustment, white matter hyperintensity score, leukocyte count on admission, and non‐Hispanic Black race (compared with non‐Hispanic White race) were associated with the presence of DWI lesions. History of ICH and ischemic stroke, presence of DWI lesions, deep ICH location (versus lobar), ICH volume, age, lower Glasgow Coma Score on admission, and medical history of diabetes were associated with poor 6‐month modified Rankin Scale outcome (4–6) after covariate adjustment. Inclusion of interactions between race and ethnicity and variables included in the final multivariable model for functional outcome improved model performance; a significant interaction between race and ethnicity and medical history of diabetes and serum blood glucose on admission was observed. No measure of hyperglycemia or diabetes was associated with presence of DWI lesions. However, both medical history of diabetes and presence of DWI lesions were independently associated with poor functional outcomes after ICH.
影响因子：
2.1
作者：
Jang SH;Kwak SG;Chang MC
通讯作者：
Chang MC