High haemoglobin levels and mortality in males with intracerebral haemorrhage: a retrospective cohort study.
High haemoglobin levels and mortality in males with intracerebral haemorrhage: a retrospective cohort study.
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男性脑出血患者的高血红蛋白水平和死亡率：一项回顾性队列研究
DOI：
10.1136/bmjopen-2020-048108
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发表时间：
2022-01-04
期刊：
影响因子：
2.9
通讯作者：
Liu M
中科院分区：
文献类型：
--
作者：
Zhang S;Shu Y;Li W;Wei C;Deng A;Cheng Y;Lei P;Liu M
目的通过一项多中心队列研究，探讨高血红蛋白水平与脑出血（ICH）预后之间的关系。设计前瞻性多中心队列研究。在中国大陆设有21家三级医院。参与者在2012年1月至2016年6月期间，共招募了5318例连续住院自发性ICH患者。主要和次要结果测量入院时测量血红蛋白水平。二元或普通逻辑回归用于评估血红蛋白水平与3个月时临床结局（以死亡或残疾衡量）的独立关系。拟合限制性三次样条回归，以检查全血红蛋白水平与3个月不良结局之间剂量-反应曲线的潜在非线性形状。结果共分析了5031例ICH患者（64.3%为男性;平均年龄（SD）为57.8（15.2）岁）。我们发现，在男性中，血红蛋白最高五分位数与3个月后的不良结局相关（调整后OR（aOR）1.65，95%CI 1.21至2.25），但在女性中则无关，这在男性患者的三个亚组的汇总分析中也观察到（平均aOR 1.70，95%CI 1.23至2.33）。样条回归表明血红蛋白水平和结局之间存在非线性关系，在男性中，血红蛋白水平升高与3个月残疾/死亡之间存在线性关系（血红蛋白水平/10 g/L：aOR 1.24，95% CI 1.10至1.40，p<0.001），这是由较大的血肿体积介导的（效应量：0.115，95% CI 0.012至0.231）。结论：本研究发现血红蛋白水平升高与3个月预后不良之间存在性别特异性相关性，这可能与较大的血肿体积有关。
Objectives To examine the association between high haemoglobin levels and outcomes in intracerebral haemorrhage (ICH) in a multicentre cohort study. Design Prospective multicentre cohort study. Settings 21 tertiary hospitals across mainland China. Participants A total of 5318 consecutive in-hospital spontaneous ICH patients were recruited between January 2012 and June 2016. Primary and secondary outcome measures Haemoglobin levels were measured on admission. Binary or ordinary logistic regression was used to evaluate the independent relationship of haemoglobin level with clinical outcomes at 3 months, measured as death or disability. Restricted cubic spline regression was fitted to examine the potential non-linear shape of the dose–response curve between the whole haemoglobin levels and 3-month poor outcomes. Results A total of 5031 patients with ICH were analysed (64.3% male; mean age (SD), 57.8 (15.2) years). We found that the highest haemoglobin quintile was associated with poor outcomes 3 months in males (adjusted OR (aOR) 1.65, 95% CI 1.21 to 2.25) but not in females, which was also observed in the pooled analysis of three subcohorts in male patients (average aOR 1.70, 95% CI 1.23 to 2.33). The spline regression suggested a non-linear association between haemoglobin levels and outcomes and a linear relationship was observed between an elevated haemoglobin level and 3-month disability/death in males (haemoglobin level per 10 g/L: aOR 1.24, 95% CI 1.10 to 1.40, p<0.001), which was mediated by larger haematoma volume (effect size: 0.115, 95% CI 0.012 to 0.231). Conclusions This study found a sex-specific association between an elevated haemoglobin level and poor 3-month outcomes, which might be mediated by larger haematoma volume.
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影响因子：
--
作者：
Zakai, NA;Katz, R;Cushman, M
通讯作者：
Cushman, M
影响因子：
5.4
作者：
Lee G;Choi S;Kim K;Yun JM;Son JS;Jeong SM;Kim SM;Park SM
通讯作者：
Park SM
影响因子：
48
作者：
van Asch, Charlotte J. J.;Luitse, Merel J. A.;Klijn, Catharina J. M.
通讯作者：
Klijn, Catharina J. M.
DOI：
10.1186/cc12827
发表时间：
2013-07-23
期刊：
Critical care (London, England)
影响因子：
--
作者：
Kuramatsu JB;Gerner ST;Lücking H;Kloska SP;Schellinger PD;Köhrmann M;Huttner HB
通讯作者：
Huttner HB
影响因子：
8.3
作者：
Panwar B;Judd SE;Warnock DG;McClellan WM;Booth JN 3rd;Muntner P;Gutiérrez OM
通讯作者：
Gutiérrez OM