Frequency and risk factors of spontaneous hemorrhagic transformation following ischemic stroke on the initial brain CT or MRI: data from the China National Stroke Registry (CNSR)
Frequency and risk factors of spontaneous hemorrhagic transformation following ischemic stroke on the initial brain CT or MRI: data from the China National Stroke Registry (CNSR)
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DOI：
10.1080/01616412.2016.1187864
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发表时间：
2016-01-01
影响因子：
1.9
通讯作者：
Wang, Yilong
中科院分区：
文献类型：
--
作者：
Chen, Guojuan;Wang, Anxin;Wang, Yilong
目的：关于缺血性卒中（IS）后自发性出血转化（HT）的研究很少，并且现有的研究并不排除入院后使用抗血栓治疗。我们的目的是调查在 IS 发病和首次神经影像学检查之间未接受治疗的患者发生自发性 HT 的频率和危险因素。方法：我们利用中国国家卒中登记中心研究自发性 HT。自发性 HT 在 IS 发病后 14 天内通过初始计算机断层扫描或磁共振成像扫描被诊断为自发性 HT。采用单因素分析和多因素Logistic回归分析评估自发性HT的危险因素。结果：共有12,415例患者被诊断为IS，其中114例（0.92%）患有自发性HT。多变量分析显示，女性比值比（OR，2.29；95% CI，1.52-3.44，p < 0.0001）、过量饮酒（OR，2.17；95% CI，1.20-3.94，p = 0.0109）、心房颤动（OR，2.15；95% CI， 1.26-3.66，p = 0.0051），并且 IS 发病和初次成像之间的时间较长（1-7 天：OR，1.64，95% CI，1.11-2.42，p = 0.0131；7-14 天：OR，3.12，95% CI，1.53-6.40，p = 0.0018）与自发性HT呈正相关。讨论：IS急性期患者中自发性HT发生率为0.92%。作为女性，过量饮酒、心房颤动以及 IS 发作和初次成像之间的时间间隔延长与自发性 HT 风险增加相关。
Objectives: There are few studies of spontaneous hemorrhagic transformation (HT) after ischemic stroke (IS), and those that are available do not preclude the use of antithrombotic therapy after admission. We aimed to investigate the frequency and risk factors of spontaneous HT in patients who received no therapy between IS onset and the first instance of neurological imaging.Methods: We studied spontaneous HT using the China National Stroke Registry. Spontaneous HT was diagnosed on an initial computed tomography or magnetic resonance imaging scan within 14 days of IS onset. The risk factors associated with spontaneous HT were assessed using univariate analyses and multivariate logistic regression.Results: A total of 12,415 patients were diagnosed with IS, and among them, 114 (0.92%) had spontaneous HT. Multivariate analysis revealed that being female odds ratio (OR, 2.29; 95% CI, 1.52-3.44, p < 0.0001), excess alcohol consumption (OR, 2.17; 95% CI, 1.20-3.94, p = 0.0109), atrial fibrillation (OR, 2.15; 95% CI, 1.26-3.66, p = 0.0051), and a prolonged period between IS onset and initial imaging (1-7 days: OR, 1.64, 95% CI, 1.11-2.42, p = 0.0131; 7-14 days: OR, 3.12, 95% CI, 1.53-6.40, p = 0.0018) were positively associated with spontaneous HT.Discussion: Spontaneous HT occurred in 0.92% of the patients with IS in the acute stage. Being female, excess alcohol consumption, atrial fibrillation, and a prolonged period between IS onset and initial imaging were associated with an increased risk of spontaneous HT.