A simple prediction score system for malignant brain edema progression in large hemispheric infarction.
A simple prediction score system for malignant brain edema progression in large hemispheric infarction.
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DOI：
10.1371/journal.pone.0171425
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Lee K
中科院分区：
文献类型：
--
作者：
Jo K;Bajgur SS;Kim H;Choi HA;Huh PW;Lee K
大脑半球梗塞引起的恶性脑水肿(MBE)可导致脑突出、预后不良和死亡；如果及早实施某些干预措施，如去骨瓣减压术，预后可能会得到改善。我们试图生成一个预测分数，以轻松识别那些MBE高危患者。纳入2011~2014年间121例大面积脑梗塞(LHI)患者。患者被分为两组：发生MBE的人和没有发生MBE的人。通过Logistic回归分析确定MBE的独立预测因素，并进行评分。有四个因素与脑梗塞独立相关：美国国立卫生研究院卒中基线评分(p=0.048)、艾伯塔省卒中计划早期计算机断层扫描评分(Aspects)(p=0.007)、侧支循环评分(p<；0.001)和血管重建失败(p=0.013)。每个因素的得分如下：NIHSS≤8(=0)，9-17(=1)，≥18(=2)；Aspects≤7(=1)，>；8(=0)；CS<；2(=1)，≥2(=0)；血管重建失败(=1)，成功(=0)。MBE分数(MBE)代表这些单项分数的总和。26例MBE评分为0~1的患者中，无一例发生MBE。MBE评分为6分的患者均发生MBE。MBE的发生和功能结局与MBE密切相关(p分别为0.007和0.002)。MBE评分是预测MBE的一种简单可靠的工具。
Malignant brain edema (MBE) due to hemispheric infarction can result in brain herniation, poor outcomes, and death; outcome may be improved if certain interventions, such as decompressive craniectomy, are performed early. We sought to generate a prediction score to easily identify those patients at high risk for MBE. 121 patients with large hemispheric infarction (LHI) (2011 to 2014) were included. Patients were divided into two groups: those who developed MBE and those who did not. Independent predictors of MBE were identified by logistic regression and a score was developed. Four factors were independently associated with MBE: baseline National Institutes of Health Stroke Scale (NIHSS) score (p = 0.048), Alberta Stroke Program Early Computed Tomography Score (ASPECTS) (p = 0.007), collateral score (CS) (p<0.001) and revascularization failure (p = 0.013). Points were assigned for each factor as follows: NIHSS ≤ 8 (= 0), 9–17 (= 1), ≥ 18 (= 2); ASPECTS≤ 7 (= 1), >8 (= 0); CS<2 (= 1), ≥2 (= 0); revascularization failure (= 1),success (= 0). The MBE Score (MBES) represents the sum of these individual points. Of 26 patients with a MBES of 0 to 1, none developed MBE. All patients with a MBES of 6 developed MBE. Both MBE development and functional outcomes were strongly associated with the MBES (p = 0.007 and 0.002, respectively). The MBE score is a simple reliable tool for the prediction of MBE.