背景:脑出血(ICH)并发酒精使用障碍(AUD)的患者的特征尚不清楚。研究该亚组(AUD-ICH)的临床特征和预后是必要的。
方法:本研究涉及2013年1月至2022年3月我院收治的年轻男性ICH患者。根据饮酒模式,将纳入的病例分为三组:AUD,偶尔喝酒,和不喝酒。比较三组患者的临床特点及预后。通过建立回归模型探讨AUD对血肿扩大和长期功能障碍的影响。通过中介分析检查了血肿密度异质性在AUD与血肿扩大之间的关系中的潜在中介作用。
结果:本研究纳入222例男性ICH患者,平均年龄54.16岁.与偶尔饮酒者相比,AUD患者发生血肿扩张和功能障碍的风险更高(血肿扩张的比值比[OR]2.966,p=0.028;功能障碍的风险比[HR]2.620,p=0.006)和不饮酒者(血肿扩张的OR3.505,p=0.011;功能障碍的HR2.795,P=0.003)。中介分析显示,血肿密度异质性对AUD与血肿扩大关系的间接影响显著,中介比例为19.3%。
结论:AUD是年轻男性ICH患者血肿扩大和长期功能障碍的独立危险因素。血肿密度异质性部分介导了AUD与血肿扩大的关系。
BACKGROUND: The characteristics of patients with intracerebral hemorrhage (ICH) complicated by alcohol use disorders (AUD) are not well understood. Investigating the clinical characteristics and prognosis of this subgroup (AUD-ICH) is necessary.
METHODS: This study involved young males with ICH who were admitted to our hospital between January 2013 and March 2022. Based on drinking patterns, the included cases were divided into three groups: AUD, occasional drinking, and non-drinking. We compared the clinical characteristics and prognosis of patients in the three groups. The effect of AUD on hematoma expansion and long-term
dysfunction was explored by developing regression models. The potential mediating role of hematoma density heterogeneity within the relationship between AUD and hematoma expansion was examined through mediation analysis.
RESULTS: This study included 222 cases of male patients with ICH, with a mean age of 54.16. AUD patients had a higher risk of hematoma expansion and
dysfunction compared to occasional drinkers (odds ratio [OR] 2.966, p=0.028 for hematoma expansion; hazard ratio [HR] 2.620, p=0.006 for
dysfunction) and non-drinkers (OR 3.505, p=0.011 for hematoma expansion; HR 2.795, P=0.003 for
dysfunction). The mediation analysis showed that the indirect effect through hematoma density heterogeneity on the relationship between AUD and hematoma expansion was significant, with a mediated proportion of 19.3%.
CONCLUSIONS: AUD was an independent risk factor for hematoma expansion and long-term
dysfunction in young male patients with ICH. Hematoma density heterogeneity partially mediated the relationship between AUD and hematoma expansion.