VOLUME OF INTRACEREBRAL HEMORRHAGE - A POWERFUL AND EASY-TO-USE PREDICTOR OF 30-DAY MORTALITY
VOLUME OF INTRACEREBRAL HEMORRHAGE - A POWERFUL AND EASY-TO-USE PREDICTOR OF 30-DAY MORTALITY
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DOI：
10.1161/01.str.24.7.987
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发表时间：
1993-07-01
期刊：
影响因子：
8.3
通讯作者：
HUSTER, G
中科院分区：
文献类型：
--
作者：
BRODERICK, JP;BROTT, TG;HUSTER, G
背景和目的：本研究的目的是确定30天的死亡率和发病率的脑出血在一个大城市的人口，并确定最重要的预测30天outcome.Methods：我们回顾了1988年期间的大辛辛那提自发性脑出血的所有病例的病历和计算机断层扫描片。30天死亡率的独立预测因素确定使用单变量和多变量statistical analysis.Results：30天的死亡率为44%的188例脑出血，与一半的死亡发生在发病的头2天。脑出血量是所有脑出血部位30天死亡率的最强预测因子。使用通过快速且易于使用的椭圆体方法计算的三种脑实质出血量（0至29 cm 3、30至60 cm 3和61 cm 3或以上）以及两种格拉斯哥昏迷量表（9或以上和8或以下），30天死亡率可以正确预测，灵敏度为96%，特异性为98%。脑实质出血量大于等于60 cm3且格拉斯哥昏迷评分小于等于8分的患者，30天死亡率为91%。体积小于30 cm 3且格拉斯哥昏迷量表评分≥ 9分的患者，预测30天死亡率为19%。71名脑实质出血量为30 cm 3或以上的患者中，只有1名患者在30天后能够独立发挥功能。结论：脑内出血量与初始格拉斯哥昏迷量表评分相结合，是自发性脑出血患者30天死亡率和发病率的强大且易于使用的预测因素。
Background and Purpose: The aim of this study was to determine the 30 -day mortality and morbidity of intracerebral hemorrhage in a large metropolitan population and to determine the most important predictors of 30-day outcome.Methods: We reviewed the medical records and computed tomographic films for all cases of spontaneous intracerebral hemorrhage in Greater Cincinnati during 1988. Independent predictors of 30-day mortality were determined using univariate and multivariate statistical analyses.Results: The 30-day mortality for the 188 cases of intracerebral hemorrhage was 44%, with half of deaths occurring within the first 2 days of onset. Volume of intracerebral hemorrhage was the strongest predictor of 30-day mortality for all locations of intracerebral hemorrhage. Using three categories of parenchymal hemorrhage volume (0 to 29 cm3, 30 to 60 cm3, and 61 cm3 or more), calculated by a quick and easy-to-use ellipsoid method, and two categories of the Glasgow Coma Scale (9 or more and 8 or less), 30-day mortality was predicted correctly with a sensitivity of 96% and a specificity of 98%. Patients with a parenchymal hemorrhage volume of 60 cm3 or more on their initial computed tomogram and a Glasgow Coma Scale score of 8 or less had a predicted 30-day mortality of 91%. Patients with a volume of less than 30 cm3 and a Glasgow Coma Scale score of 9 or more had a predicted 30-day mortality of 19%. Only one of the 71 patients with a volume of parenchymal hemorrhage of 30 cm3 or more could function independently at 30 days.Conclusions: Volume of intracerebral hemorrhage, in combination with the initial Glasgow Coma Scale score, is a powerful and easy-to-use predictor of 30-day mortality and morbidity in patients with spontaneous intracerebral hemorrhage.