intracranial tumor

颅内肿瘤
  • 文章类型: Journal Article
    背景:脑膜瘤是最常见的原发性脑肿瘤,起源于脑膜-围绕大脑和脊髓的保护膜。脑膜瘤的几个充分研究的危险因素包括性别,年龄,辐射暴露,遗传因素,和荷尔蒙因素。此外,一个人的心理情绪状态对其整体健康和心理健康的影响,特别是压力,目前是一个重要和相关的讨论话题。
    目的:本病例对照研究旨在研究感知压力之间的关联,慢性压力,和成年患者的脑膜瘤。
    结果:研究包括病例,其中包括经组织学证实的脑膜瘤的成年患者,和控制,由无脑癌病史的成年患者组成。数据收集涉及使用三种类型的问卷。第一份问卷侧重于患者的个人信息,地理因素,和生活习惯。另外两份问卷“感知压力量表”和“慢性压力量表”用于评估感知压力和慢性压力。询问是由神经科医生进行的。使用MicrosoftExcel和Stata14进行数据分析。总的来说,148份问卷完成并纳入分析。参与者的平均年龄为45.60±13.90岁。两组中女性人数都超过男性。与没有脑膜瘤的患者相比,诊断为脑膜瘤的患者具有更高的感知高压力水平(p=.045)。没有脑膜瘤诊断的受访者报告说,在一般和环境问题上有更多的慢性压力(p=.004),财务问题(p=.006),工作(p<.001),无就业(p=.008),爱情与婚姻(p<.001),隔离(p<.001),和住所(p<.001)。脑膜瘤患者,然而,与无脑膜瘤患者相比,慢性应激较少。
    结论:这项研究显示,在我们的研究样本中,应激和脑膜瘤之间没有明显的联系。有必要进行更大样本量的匹配病例对照方法的进一步研究,以彻底评估压力在脑膜瘤患者中的潜在作用。
    BACKGROUND: Meningiomas are the most common type of primary brain tumor, originating from the meninges - the protective membranes that surround the brain and spinal cord. Several well-studied risk factors for meningiomas include gender, age, radiation exposure, genetic factors, and hormonal factors. Moreover, the influence of a person\'s psycho-emotional stateon their overall health and mental well-being, specifically stress, iscurrently a significant and relevant topic of discussion.
    OBJECTIVE: This case-control study aimed to study the association between perceived stress, chronic stress, and meningioma in adult patients.
    RESULTS: The study included cases, which comprised adult patients with histologically confirmed meningioma, and controls, consisting of adult patients with no history of brain cancer. Data collection involved the use of three types of questionnaires. The first questionnaire focused on patients\' personal information, geographic factors, and lifestyle habits. Two additional questionnaires \"The Perceived Stress Scale\" and \"The Chronic Stress Scale\" were employed to assess perceived stress and chronic stress. The questioning was conducted by a neurologist. Microsoft Excel and Stata 14 were used for the data analysis. Overall, 148 questionnaires were completed and included in the analyses. The average age of participants was 45.60 ± 13.90 years. Females outnumbered males in both groups. Patients with meningioma diagnosis had a higher level of perceived high stress compared to those without meningioma (p = .045). Respondents without a diagnosis of meningioma have reported having more chronic stress in general and ambient problems (p = .004), financial issues (p = .006), work (p < .001), non-employment (p = .008), love and marriage (p < .001), isolation (p < .001), and residence (p < .001). Patients with meningioma, however, had less chronic stress compared to meningioma-free patients.
    CONCLUSIONS: This study revealed no discernible connection between stress and meningioma within our study sample. Further research with matched case-control methodology with a larger sample size is warranted to thoroughly evaluate the potential role of stress in patients with meningioma.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    白细胞(WBC)计数已被确定为预后生物标志物,其经常预测各种情况下的不良后果和死亡风险。然而,WBC计数与颅内肿瘤切除术后短期结局之间的相关性的证据仍然有限.本研究旨在探讨成人颅内肿瘤患者术前白细胞计数与开颅手术后30天手术死亡率之间的关系。
    这项回顾性队列研究对ACSNSQIP数据库(2012-2015)中的18,049例颅内肿瘤开颅手术患者进行了二次分析。主要暴露和结果为术前白细胞计数和30天手术死亡率。分别。Cox回归模型评估了它们之间的线性关联。通过使用加性Cox比例风险模型结合分段线性回归模型进行平滑曲线拟合来评估它们之间的非线性关联。亚组分析和相互作用测试评估了效果修改。敏感性分析评估了结果的稳健性。
    开颅手术后30天的总死亡率为2.49%(450/18,049)。术前白细胞计数平均值为9.501±4.402×10^9/L完全校正模型显示术前白细胞计数升高与30天手术死亡率升高独立相关(HR=1.057,95CI:1.040,1.076)。进一步分析揭示了它们之间的非线性关联:低于13.6×10^9/L的WBC阈值,白细胞计数较高,30天死亡率升高(HR=1.117;95CI:1.077,1.158),而风险趋于稳定,死亡率没有明显上升(HR=1.015,95CI:0.982,1.050)。类固醇使用状态对WBC-死亡率关联具有显著影响(相互作用的P=0.002)。非线性WBC-死亡率关联仅存在于非类固醇使用者(HR=1.158,95CI:1.108,1.210),而不是类固醇使用者(HR=1.009,95CI:0.966,1.055)。灵敏度分析证实了结果的稳健性。
    术前白细胞计数升高与接受颅内肿瘤开颅手术的成人非类固醇治疗患者30天手术死亡率风险增加独立且非线性相关。作为一个方便的预测器,术前WBC数据可以改善成人颅内肿瘤患者的风险分析和个性化管理.
    UNASSIGNED: White blood cell (WBC) counts has been identified as a prognostic biomarker which frequently predict adverse outcomes and mortality risk in various conditions. However, evidence for the association between WBC counts and short-term outcomes after intracranial tumor resection remains limited. This study aimed to explore associations between preoperative WBC counts and thirty-day surgical mortality after craniotomy in adult intracranial tumor patients.
    UNASSIGNED: This retrospective cohort study performed secondary analysis of 18,049 intracranial tumor craniotomy patients from the ACS NSQIP database (2012-2015). The major exposure and outcome were preoperative WBC counts and thirty-day surgical mortality, respectively. Cox regression modeling assessed the linear association between them. Non-linear associations between them were evaluated by conducting smooth curve fitting using an additive Cox proportional hazard model in conjunction with segmented linear regression modeling. Subgroup analysis and interaction testing assessed effect modification. Sensitivity analysis evaluated result robustness.
    UNASSIGNED: The total thirty-day surgical mortality after craniotomy was 2.49% (450/18,049). The mean of preoperative WBC counts was 9.501 ± 4.402 × 10^9/L. Fully adjusted model shows that elevated preoperative WBC counts was independently associated with increased thirty-day surgical mortality (HR = 1.057, 95%CI: 1.040, 1.076). Further analysis revealed a non-linear association between them: below a WBC threshold of 13.6 × 10^9/L, higher WBC counts elevated thirty-day mortality (HR = 1.117; 95%CI: 1.077, 1.158), while risk plateaued and no significant mortality rise occurred above this level (HR = 1.015, 95%CI: 0.982, 1.050). Steroid usage status has a significant effect modification on the WBC-mortality association (P for interaction = 0.002). The non-linear WBC-mortality association was only present for non-steroid users (HR = 1.158, 95%CI: 1.108, 1.210) but not steroid users (HR = 1.009, 95%CI: 0.966, 1.055). The sensitivity analysis confirmed the result robustness.
    UNASSIGNED: Elevated preoperative WBC counts were independently and non-linearly associated with an increased risk of thirty-day surgical mortality in adult non-steroid use patients undergoing craniotomy for intracranial tumors. As a convenient predictor, preoperative WBC data allows improved risk profiling and personalized management in adult intracranial tumor patients.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    孤立性纤维性肿瘤(SFT)是起源于间充质组织的罕见梭形细胞肿瘤,当它发生在颅内时甚至更罕见。该病例报告描述了一名42岁的男子,他出现头痛和肢体无力超过10天。磁共振成像(MRI)显示左枕区有一个明确的多室囊性占位性病变,周围水肿和左侧侧脑室受压,生长在小脑软骨上的物质,最初被诊断为血管母细胞瘤。神经外科手术被成功地切除了肿块,术后病理分析发现颅内孤立性纤维瘤(ISFT)。这里,本文介绍一例囊性颅内孤立性纤维瘤的影像学表现及病理特点,旨在提高对本病的认识和诊断,以提供准确的治疗方案。
    Solitary fibrous tumor (SFT) is a rare spindle cell tumor originating from mesenchymal tissue, and even rarer when it occurs intracranially. This case report described a 42-year-old man who presented with headache and limb weakness for more than 10 days. Magnetic resonance imaging (MRI) showed a well-defined multicompartmental cystic space-occupying lesion in the left occipital region, with surrounding edema and a compressed left lateral ventricle, the mass growing across the cerebellar vermis, which was initially diagnosed as hemangioblastoma. Neurosurgery was utilized to successfully remove the mass, and intracranial solitary fibrous tumor (ISFT) was identified by postoperative pathological analysis. Here, this article describes the imaging manifestations and pathologic features of a case of cystic intracranial solitary fibrous tumor, aiming to improve the understanding and diagnosis of this disease in order to provide an accurate therapy plan.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:可以通过融合MR和CT图像来实现信息互补,融合图像具有丰富的软组织和骨骼信息,有助于准确的辅助诊断和肿瘤靶点勾画。
    目的:本研究的目的是基于颅内肿瘤的MR和CT图像,利用Res2Net(Res2Net)方法构建高质量的融合图像。
    方法:本文提出了一种基于Res2Net的MR和CT图像融合方法。该方法包括三个组件:特征提取器,融合层,和重建器。特征提取器利用Res2Net框架从源图像中提取多尺度特征。融合层结合了基于空间平均注意力的融合策略,自适应调整每个位置的特征图的融合权重,以保留源图像的精细细节。最后,将融合特征输入到特征重建器以重建融合图像。
    结果:定性结果表明,所提出的融合方法表现出清晰的边界轮廓和肿瘤区域的准确定位。定量结果表明,该方法实现了平均梯度,空间频率,熵,和视觉信息保真度的融合度量分别为4.6771、13.2055、1.8663和0.5176。综合实验结果表明,与先进的融合算法相比,该方法在融合图像中保留了更多的纹理细节和结构信息,减少光谱伪影和信息损失,并在视觉质量和客观指标方面表现更好。
    结论:所提出的方法有效地结合了MR和CT图像信息,允许肿瘤区域边界的精确定位,协助临床医生进行临床诊断。
    BACKGROUND: Information complementarity can be achieved by fusing MR and CT images, and fusion images have abundant soft tissue and bone information, facilitating accurate auxiliary diagnosis and tumor target delineation.
    OBJECTIVE: The purpose of this study was to construct high-quality fusion images based on the MR and CT images of intracranial tumors by using the Residual-Residual Network (Res2Net) method.
    METHODS: This paper proposes an MR and CT image fusion method based on Res2Net. The method comprises three components: feature extractor, fusion layer, and reconstructor. The feature extractor utilizes the Res2Net framework to extract multiscale features from source images. The fusion layer incorporates a fusion strategy based on spatial mean attention, adaptively adjusting fusion weights for feature maps at each position to preserve fine details from the source images. Finally, fused features are input into the feature reconstructor to reconstruct a fused image.
    RESULTS: Qualitative results indicate that the proposed fusion method exhibits clear boundary contours and accurate localization of tumor regions. Quantitative results show that the method achieves average gradient, spatial frequency, entropy, and visual information fidelity for fusion metrics of 4.6771, 13.2055, 1.8663, and 0.5176, respectively. Comprehensive experimental results demonstrate that the proposed method preserves more texture details and structural information in fused images than advanced fusion algorithms, reducing spectral artifacts and information loss and performing better in terms of visual quality and objective metrics.
    CONCLUSIONS: The proposed method effectively combines MR and CT image information, allowing the precise localization of tumor region boundaries, assisting clinicians in clinical diagnosis.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    中枢神经细胞瘤,一种罕见的颅内肿瘤,主要位于侧脑室和第三脑室,由于其不同的临床表现,提出了诊断和治疗的挑战。我们报告了一例53岁的男性,表现为右上下肢无力,头痛,视力模糊,和刺痛的感觉,导致中枢神经细胞瘤与相关脑积水的诊断。初步评估,包括磁共振成像(MRI)和随后的计算机断层扫描(CT)扫描,揭示了肿瘤的特征。病人接受了两阶段的外科手术,包括肿瘤切除和脑室腹膜分流术,术后因呼吸道并发症进行气管造口术。组织病理学检查证实诊断为中枢神经细胞瘤,促进多学科管理和进一步转诊以进行长期随访。这一案例凸显了综合评价的重要性,多学科合作,并继续研究优化中枢神经细胞瘤的诊断和治疗。
    Central neurocytoma, a rare intracranial tumor predominantly located in the lateral and third ventricles, presents a diagnostic and therapeutic challenge due to its varied clinical manifestations. We report the case of a 53-year-old male presenting with right upper and lower limb weakness, headaches, blurred vision, and tingling sensations, leading to the diagnosis of central neurocytoma with associated hydrocephalus. Initial evaluation, including magnetic resonance imaging (MRI) and subsequent computed tomography (CT) scans, revealed characteristic features of the tumor. The patient underwent a two-stage surgical intervention, including tumor excision and ventriculoperitoneal shunting, followed by a tracheostomy due to respiratory complications post-surgery. Histopathological examination confirmed the diagnosis of central neurocytoma, prompting multidisciplinary management and further referral for long-term follow-up. This case underscores the importance of comprehensive evaluation, multidisciplinary collaboration, and continued research in optimizing the diagnosis and management of central neurocytomas.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    引言术前栓塞可能有助于手术切除颅内和面部区域的挑战性肿瘤;然而,其临床疗效仍存在争议,主要是由于潜在的发病风险。我们探讨了术前栓塞和肿瘤切除联合治疗影响神经系统预后的不利因素。方法这项回顾性研究使用了2016年1月至2021年5月在多个机构接受联合治疗的132例连续肿瘤的临床数据。患者基本信息,肿瘤特征,和治疗细节进行评估,以确定治疗后3个月使用改良Rankin量表(mRS)评分测量的恶化预测因子.结果在126个符合条件的联合治疗中,在19/126(15.1%)中观察到术后mRS评分恶化.与栓塞和肿瘤切除相关的并发症发生在8/126(6.3%)和19/125(15.2%)的手术中,分别。多变量分析表明,栓塞材料的迁移之间存在显着关联(调整后的比值比13.80;95%置信区间1.25-152.52;p=0.03),术中失血量升高(p=0.04),术后mRS评分恶化。栓塞材料迁移被确定为评分恶化的主要预后因素。对192个程序的分析,不包括那些专门使用线圈的,确定针对副脑膜动脉(p=0.046)和上颌内动脉第三段(p=0.03)的栓塞是栓塞材料迁移的危险因素。结论:栓塞性物质迁移是联合治疗后持续到慢性期的神经系统预后下降的主要因素。鉴于术前栓塞是一种补充治疗选择,彻底了解血管解剖结构和确保安全的手术至关重要。
    Introduction Preoperative embolization can potentially facilitate surgical resection of challenging tumors in the intracranial and facial regions; however, its clinical efficacy remains controversial, mainly due to potential morbidity risks. We explored negative factors of the combined treatment of preoperative embolization and tumor resection that affect neurological prognosis. Method This retrospective study used clinical data from 132 consecutive tumors that underwent combined treatment at multiple facilities between January 2016 and May 2021. Basic patient information, tumor characteristics, and treatment details were assessed to identify predictors of deterioration as measured using the modified Rankin scale (mRS) score at three months post-treatment. Results Among the 126 eligible combined treatments, a deterioration in the postoperative mRS score was observed in 19/126 (15.1%). Complications related to embolization and tumor resection occurred in 8/126 (6.3%) and 19/125 (15.2%) of procedures, respectively. Multivariate analyses indicated significant associations between migration of embolic material (adjusted odds ratio 13.80; 95% confidence interval 1.25-152.52; p=0.03), elevated intraoperative blood loss (p=0.04), and deterioration of postoperative mRS score. Embolic material migration was identified as the primary prognostic factor for the deterioration of score. An analysis of 192 procedures, excluding those that exclusively used coils, identified embolization targeting the accessory meningeal artery (p=0.046) and the third segment of the internal maxillary artery (p=0.03) as a risk factor for embolic material migration. Conclusions Embolic material migration is the predominant factor associated with declining neurological outcome that persists into the chronic phase after combined treatment. Given that preoperative embolization is a supplementary treatment option, a thorough understanding of vascular anatomy and striving safe procedure are critical.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:骨受累的脑膜瘤占所有颅内脑膜瘤的4.5-17%。对于这些脑膜瘤(WHOI级)的行为是否与没有骨骼参与的脑膜瘤不同,知之甚少。我们试图研究脑膜瘤相对罕见的影像学表现并评估其临床意义。
    方法:对2011年至2022年接受手术治疗的浅表脑膜瘤患者进行了单机构回顾性队列研究。年龄,性别,术前成像,手术数据,并对手术结果进行了回顾。报告了骨侵入性脑膜瘤患者的影像学变量和结果,并与非骨侵入性脑膜瘤患者进行了比较。还进行了单变量分析。
    结果:在577例经手术治疗的浅表脑膜瘤中,47例(8.1%)出现骨侵犯。大多数骨侵袭性脑膜瘤是矢状旁瘤(n=29,61.7%)。共有12.7%(n=6)的骨侵犯脑膜瘤患者复发,而9.1%(n=48)的非骨侵犯脑膜瘤患者复发(p=0.426)。骨侵袭性脑膜瘤患者和非骨侵袭性脑膜瘤患者的中位复发时间没有显着差异(69.8个月,Q1:53.1;Q3:81.4个月与69.7个月,Q1:47.5;Q3:96.7;p=0.638)。
    结论:与没有骨受累的浅表脑膜瘤相比,有骨受累的浅表脑膜瘤具有相似的结局。脑膜瘤的骨增生(WHOI级)可能不是侵袭性脑膜瘤行为的替代品。
    BACKGROUND: Meningiomas with bone involvement account for 4.5-17% of all intracranial meningiomas. Little is known about whether these meningiomas (WHO grade I) behave differently than meningiomas without bone involvement. We sought to study the relatively uncommon imaging manifestations of meningioma and to evaluate their clinical significance.
    METHODS: A single-institution retrospective cohort study of surgically treated superficial meningioma patients between 2011 and 2022 was conducted. Age, sex, preoperative imaging, operative data, and surgical outcomes were reviewed. Imaging variables and outcomes were reported for patients with bone-invading meningiomas and compared with those with nonbone-invading meningiomas. Univariate analyses were also conducted.
    RESULTS: Of 577 total superficial meningiomas treated surgically, 47 (8.1%) exhibited bone invasion. Most bone-invading meningiomas were parasagittal (n = 29, 61.7%). A total of 12.7% (n = 6) of patients with bone-invading meningioma had recurrence, whereas 9.1% (n = 48) of patients with non-bone-invading meningioma had recurrence (p = 0.426). No significant difference in the median time to recurrence was observed between patients with bone-invading meningiomas and patients with nonbone-invading meningiomas (69.8 months, Q1:53.1; Q3:81.4 months vs. 69.7 months, Q1:47.5; Q3:96.7; p = 0.638).
    CONCLUSIONS: Superficial meningioma with bone involvement had similar outcomes compared to those of superficial meningioma without bone involvement. Hyperostosis in meningioma (WHO grade I) may not be a surrogate for aggressive meningioma behavior.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    中枢神经系统肿瘤的临床相关和可靠模型的开发在推进神经肿瘤学领域中起着重要作用。原位颅内注射被广泛用于研究生长,入侵,和肿瘤在受控环境中扩散。进行原位模型以检查从动物模型中的相同部位或位置的患者的特定区域分离的肿瘤细胞。原位脑肿瘤模型也用于治疗剂的临床前测试,因为它们紧密地概括了此类癌症的行为和患者的脑环境。下面,我们描述了我们在儿童脑肿瘤包括弥漫性中线神经胶质瘤(DMG)的小鼠模型的发展经验,胶质母细胞瘤(GBM),和髓母细胞瘤.该方法提供了小鼠颅内立体定向注射的概述。
    The development of clinically relevant and reliable models of central nervous system tumors has been instrumental in advancing the field of Neuro-Oncology. The orthotopic intracranial injection is widely used to study the growth, invasion, and spread of tumors in a controlled environment. Orthotopic models are performed to examine tumor cells isolated from a specific region in a patient in the same site or location in an animal model. Orthotopic brain tumor models are also utilized for preclinical testing of therapeutics as they closely recapitulate the behavior of such cancer and the brain environment of patients. Below, we describe our experiences in the development of murine models of pediatric brain tumors including diffuse midline glioma (DMG), glioblastoma (GBM), and medulloblastoma. The method provides an overview of intracranial stereotactic injections in mice.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Case Reports
    原发性结外边缘区粘膜相关淋巴样组织B细胞淋巴瘤(EMZMBCL),表现为硬脑膜肿块,是一种罕见的颅内肿瘤,模仿硬膜下血肿或脑膜瘤。
    一名49岁的妇女因短暂性右上肢轻瘫来到我们医院,构音障碍10分钟,和持续的右上肢麻木。头部计算机断层扫描(CT)显示左额叶和顶叶的轴外病变。根据急诊室最初的CT检查结果,怀疑有急性硬膜下血肿.然而,脑膜瘤和其他颅内肿瘤也被列为鉴别诊断,因为血液检查没有头部外伤或凝血异常的病史,并进行了进一步的影像学研究.影像学发现提示硬膜下肿瘤病变。对病变进行了部分切除。根据组织病理学和免疫组织化学检查,患者被诊断为EMZMBCL.全脑和强度调节放射疗法作为辅助疗法施用。患者出院,无神经功能缺损。
    EMZMBCL是一种罕见疾病,在硬膜下病变的鉴别诊断中应考虑,特别是当没有外伤史或凝血系统异常时。选择放疗作为辅助治疗后,患者预后良好。
    UNASSIGNED: Primary extranodal marginal zone mucosa-associated lymphoid tissue-type B-cell lymphoma (EMZMBCL), which presents as a dural mass, is a rare intracranial tumor that mimics a subdural hematoma or meningioma.
    UNASSIGNED: A 49-year-old woman presented to our hospital with transient right upper limb paresis, dysarthria for 10 min, and ongoing right upper-limb numbness. Computed tomography (CT) of the head revealed extra-axial lesions in the left frontal and parietal lobes. Based on the initial CT findings in the emergency room, an acute subdural hematoma was suspected. However, meningiomas and other intracranial tumors were also listed as differential diagnoses because there was no history of head trauma or coagulation abnormalities on blood examination, and further imaging studies were performed. Imaging findings suggested a subdural neoplastic lesion. A partial resection was performed for the lesion. Based on histopathological and immunohistochemical examinations, the patient was diagnosed with EMZMBCL. Whole-brain and intensity-modulated radiation therapies were administered as adjuvant therapies. The patient was discharged without neurological deficits.
    UNASSIGNED: EMZMBCL is a rare disease that should be considered in the differential diagnosis of subdural lesions, especially when there is no history of trauma or abnormalities in the coagulation system. The patient had a favorable outcome after selecting radiotherapy as the adjuvant therapy.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:社会经济地位(SES)是生活质量和结果的主要决定因素。然而,SES仍然难以全面衡量。困境社区指数(DCI),七个社会经济因素的综合,越来越多的人认识到它与不良结果的相关性。
    目的:确定DCI对颅内肿瘤手术后预后的预测价值。
    方法:单一机构,我们进行了回顾性审查,以确定接受手术切除的成人颅内肿瘤患者(2016-2021年).患者邮政编码与DCI匹配,并按DCI四分位数进行分层(低:0-24.9,低-中:25-49.9,中-高:50-74.9,高:75-100)。单变量和多变量回归评估DCI对术后结果的影响。产生显著结果的受试者工作曲线(ROC)。
    结果:共纳入2,389名患者:1,015名患者(42.5%)居住在低痛苦社区,689(28.8%)在低中度痛苦社区,445(18.6%)在中高危难社区,和240(10.0%)在高痛苦社区。在多变量分析中,骨折风险(校正比值比[aOR]=1.60,95%置信区间[CI]1.26-2.05,p<0.001)和90天死亡率(aOR=1.58,95CI1.21-2.06,p<0.001)随DCI四分位数的增加而增加.这两个模型都具有良好的预测准确性,骨折的ROC为0.746(95CI0.720-0.766),90天死亡率为0.743(95CI0.714-0.772)。
    结论:来自痛苦社区的颅内肿瘤患者在术后发生不良事件和死亡的风险增加。DCI可能是有用的,SES的整体测量可以帮助对患者进行风险分层,在建立医疗保健途径时应予以考虑。
    Socioeconomic status (SES) is a major determinant of quality of life and outcomes. However, SES remains difficult to measure comprehensively. Distress communities index (DCI), a composite of 7 socioeconomic factors, has been increasingly recognized for its correlation with poor outcomes. As a result, the objective of the present study is to determine the predictive value of the DCI on outcomes following intracranial tumor surgery.
    A single institution, retrospective review was conducted to identify adult intracranial tumor patients undergoing resection (2016-2021). Patient ZIP codes were matched to DCI and stratified by DCI quartiles (low:0-24.9, low-intermediate:25-49.9, intermediate-high:50-74.9, high:75-100). Univariate followed by multivariate regressions assessed the effects of DCI on postoperative outcomes. Receiver operating curves were generated for significant outcomes.
    A total of 2389 patients were included: 1015 patients (42.5%) resided in low distress communities, 689 (28.8%) in low-intermediate distress communities, 445 (18.6%) in intermediate-high distress communities, and 240 (10.0%) in high distress communities. On multivariate analysis, risk of fracture (adjusted odds ratio = 1.60, 95% confidence interval 1.26-2.05, P < 0.001) and 90-day mortality (adjusted odds ratio = 1.58, 95% confidence interval 1.21-2.06, P < 0.001) increased with increasing DCI quartile. Good predictive accuracy was observed for both models, with receiver operating curves of 0.746 (95% CI 0.720-0.766) for fracture and 0.743 (95% CI 0.714-0.772) for 90-day mortality.
    Intracranial tumor patients from distressed communities are at increased risk for adverse events and death in the postoperative period. DCI may be a useful, holistic measure of SES that can help risk stratifying patients and should be considered when building healthcare pathways.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

公众号