Satellite Sign: A Poor Outcome Predictor in Intracerebral Hemorrhage
Satellite Sign: A Poor Outcome Predictor in Intracerebral Hemorrhage
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DOI：
10.1159/000477179
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发表时间：
2017-01-01
影响因子：
2.9
通讯作者：
Tominaga, Teiji
中科院分区：
文献类型：
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作者：
Shimoda, Yoshiteru;Ohtomo, Satoru;Tominaga, Teiji
背景：脑出血（ICH）周围偶尔可见高密度星形点，我们称之为卫星征。伴有卫星标志的脑出血与其功能预后之间的关系尚未确定。本研究旨在确定卫星征象的存在是否可以作为脑出血患者的独立预后因素。方法：回顾性分析急性自发性脑出血患者，并回顾其初始CT扫描。卫星征象定义为至少在单轴片上与主出血完全分离的分散的高密度病变。出院时使用改良Rankin量表（mRS）评估功能结局。功能预后差定义为mRS评分为3-6分。应用单变量和多变量逻辑回归分析来评估卫星标志的存在及其与不良功能预后的关系。结果：共有241例脑出血患者纳入研究。其中98例（40.7%）有卫星征。有卫星征象的患者的功能预后不良率（95.9%）明显高于无卫星征象的患者（55.9%,p < 0.0001）。多因素logistic回归分析显示，年龄较大（OR 1.06; 95% CI 1.03-1.10; p = 0.00016）、出血面积较大（OR 1.06; 95% CI 1.03-1.11; p = 0.00015）、伴有卫星征的脑出血（OR 13.5; 95% CI 4.42-53.4; p < 0.0001）与预后不良显著相关。卫星征与较高的收缩压（p = 0.0014）、较高的舒张压（p = 0.0117）、较短的活化血栓活酶时间（p = 0.0427）、较高的脑室内出血率（p < 0.0001）和较大的主出血（p < 0.0001）显著相关。结论：初次CT扫描中出现卫星征与脑出血患者的功能预后显著恶化相关。(C) 2017 S. Karger AG，巴塞尔
Background: The presence of high-density starry dots around the intracerebral hemorrhage (ICH), which we termed as a satellite sign, is occasionally observed in CT. The relationship between ICH with a satellite sign and its functional outcome has not been identified. This study aimed to determine whether the presence of a satellite sign could be an independent prognostic factor for patients with ICH. Methods: Patients with acute spontaneous ICH were retrospectively identified and their initial CT scans were reviewed. A satellite sign was defined as scattered high-density lesions completely separate from the main hemorrhage in at least the single axial slice. Functional outcome was evaluated using the modified Rankin Scale (mRS) at discharge. Poor functional outcome was defined as mRS scores of 3-6. Univariate and multivariate logistic regression analyses were applied to assess the presence of a satellite sign and its association with poor functional outcome. Results: A total of 241 patients with ICH were enrolled in the study. Of these, 98 (40.7%) had a satellite sign. Patients with a satellite sign had a significantly higher rate of poor functional outcome (95.9%) than those without a satellite sign (55.9%, p < 0.0001). Multivariate logistic regression analysis revealed that higher age (OR 1.06; 95% CI 1.03-1.10; p = 0.00016), large hemorrhage size (OR 1.06; 95% CI 1.03-1.11; p = 0.00015), and ICH with a satellite sign (OR 13.5; 95% CI 4.42-53.4; p < 0.0001) were significantly related to poor outcome. A satellite sign was significantly related with higher systolic blood pressure (p = 0.0014), higher diastolic blood pressure (p = 0.0117), shorter activated partial thromboplastin time (p = 0.0427), higher rate of intraventricular bleeding (p < 0.0001), and larger main hemorrhage (p < 0.0001). Conclusions: The presence of a satellite sign in the initial CT scan is associated with a significantly worse functional outcome in ICH patients. (C) 2017 S. Karger AG, Basel