目的:建立深部脑出血患者血肿累及部位与血肿扩大(HE)的关系。
方法:这项回顾性多中心研究包括2018年至2020年发病6小时内住院的深度ICH患者。排除患有继发性ICH的个体。根据入院和随访计算机断层扫描评估HE的体积。使用多变量逻辑回归分析,同时调整HE的混杂协变量,检查了深部ICH受累部位与HE之间的关联。
结果:我们纳入了来自三个卒中中心的583名个体。最终总共460名患者的数据被用于分析;在这些患者中,159人(34.6%)患有HE。在没有调整的粗略模型中,外囊,内囊前肢,内囊后肢(PLIC)受累与HE相关。在完全调整了性别模型之后,年龄,脑室内出血,格拉斯哥昏迷量表录取分数,基线ICH体积,以及从发病到初始计算机断层扫描的时间,多变量逻辑回归显示,PLIC是深部ICH患者HE的可靠预测因子(校正比值比=2.73;95%置信区间=1.75-4.26;p<0.001)。
结论:深度出血中内囊后肢的受累可能是HE的一个有希望的预测指标。
OBJECTIVE: To establish the relationship between hematoma sites of involvement and hematoma expansion (HE) in patients with
deep intracerebral hemorrhage (ICH).
METHODS: Eligible patients with
deep ICH admitted to hospital within 6 hours of onset between 2018 and 2020 were included in this retrospective multi-center study. Individuals with secondary ICH were excluded. The volume of HE was evaluated based on admission and follow-up computed tomography scans. Associations between
deep ICH sites of involvement and HE were examined using multivariable logistic regression analysis while adjusting for confounding covariates of HE.
RESULTS: We enrolled 583 individuals from three stroke centers. Data from a final total of 460 patients were used in the analysis; of these patients, 159 (34.6%) had HE. In the crude model without adjustment, external capsule, anterior limb of the internal capsule, and posterior limb of the internal capsule (PLIC) involvement were correlated with HE. After fully adjusted models for sex, age, intraventricular hemorrhage, Glasgow Coma Scale admission score, baseline ICH volume, and time from onset to initial computed tomography, multivariable logistic regression revealed that the PLIC is a robust predictor of HE in patients with
deep ICH (adjusted odds ratio = 2.73; 95% confidence interval = 1.75-4.26; p < 0.001).
CONCLUSIONS: Involvement of the posterior limb of the internal capsule in
deep hemorrhage could be a promising predictor of HE.