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学科主题: 临床医学
题名:
Predictors of Late Neurological Deterioration After Spontaneous Intracerebral Hemorrhage
作者: Sun, Weiping1,2; Pan, Wenqin1; Kranz, Peter G.3; Hailey, Claire E.4; Williamson, Rachel A.4; Sun, Wei2; Laskowitz, Daniel T.1,4,5,6; James, Michael L.4,5,6
关键词: Intracerebral hemorrhage ; Neurological deterioration ; Predictors ; Outcome ; Brain edema
刊名: NEUROCRITICAL CARE
发表日期: 2013-12-01
DOI: 10.1007/s12028-013-9894-2
卷: 19, 期:3, 页:299-305
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Critical Care Medicine ; Clinical Neurology
研究领域[WOS]: General & Internal Medicine ; Neurosciences & Neurology
关键词[WOS]: ACTIVATED FACTOR-VII ; EMERGENCY-DEPARTMENT ; PERIHEMATOMAL EDEMA ; APOLIPOPROTEIN-E ; STROKE ; BLOOD ; HYPERGLYCEMIA ; ASSOCIATION ; INJURY ; VOLUME
英文摘要:

Although intracerebral hemorrhage (ICH) is a common form of cerebrovascular disease, little is known about factors leading to neurological deterioration occurring beyond 48 h after hematoma formation. The purpose of this study was to characterize the incidence, consequences, and associative factors of late neurological deterioration (LND) in patients with spontaneous ICH.

Using the Duke University Hospital Neuroscience Intensive Care Unit database from July 2007 to June 2012, a cohort of 149 consecutive patients with spontaneous supratentorial ICH met criteria for analysis. LND was defined as a decrease of two or more points in Glasgow Coma Scale score or death during the period from 48 h to 1 week after ICH symptom onset. Unfavorable outcome was defined as a modified Rankin Scale score of > 2 at discharge.

Forty-three subjects (28.9 %) developed LND. Logistic regression models revealed hematoma volume (OR = 1.017, 95 % CI 1.003-1.032, p = 0.019), intraventricular hemorrhage (OR = 2.519, 95 % CI 1.142-5.554, p = 0.022) and serum glucose on admission (OR = 2.614, 95 % CI 1.146-5.965, p = 0.022) as independent predictors of LND. After adjusting for ICH score, LND was independently associated with unfavorable outcome (OR = 4.000, 95 % CI 1.280-12.500, p = 0.017). In 65 subjects with follow-up computed tomography images, an increase in midline shift, as a surrogate for cerebral edema, was independently associated with LND (OR = 3.822, 95 % CI 1.157-12.622, p = 0.028).

LND is a common phenomenon in patients with ICH; further, LND appears to affect outcome. Independent predictors of LND include hematoma volume, intraventricular hemorrhage, and blood glucose on admission. Progression of perihematomal edema may be one mechanism for LND.

语种: 英语
所属项目编号: D43-TW008308-01
项目资助者: NIH ; American Heart Association-Scientist Development Grant
WOS记录号: WOS:000327393200007
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/65824
Appears in Collections:北京大学第一临床医学院_神经内科_期刊论文

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作者单位: 1.Duke Univ, Duke Clin Res Inst, Durham, NC USA
2.Duke Univ, Dept Radiol Neuroradiol, Durham, NC USA
3.Peking Univ, Hosp 1, Dept Neurol, Beijing 100871, Peoples R China
4.Duke Univ, Dept Anesthesiol, DUMC 3094, Durham, NC 27710 USA
5.Duke Univ, Dept Neurol, Durham, NC USA
6.Duke Univ, Brain Injury Translat Res Ctr, Durham, NC 27705 USA

Recommended Citation:
Sun, Weiping,Pan, Wenqin,Kranz, Peter G.,et al. Predictors of Late Neurological Deterioration After Spontaneous Intracerebral Hemorrhage[J]. NEUROCRITICAL CARE,2013,19(3):299-305.
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