Clinical characteristics and functional dependent risk of intracerebral hemorrhage in patients with nephrotic syndrome

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2024-09-25 DOI:10.1016/j.jstrokecerebrovasdis.2024.108038

Wen-Yi Huang MD, Ph.D , Chun-Wei Chang MD , Kuan-Hsing Chen MD, Ph.D , Chien-Hung Chang MD , Hsiu-Chuan Wu MD, Ph.D , Kuo-Hsuan Chang MD, Ph.D

{"title":"Clinical characteristics and functional dependent risk of intracerebral hemorrhage in patients with nephrotic syndrome","authors":"Wen-Yi Huang MD, Ph.D , Chun-Wei Chang MD , Kuan-Hsing Chen MD, Ph.D , Chien-Hung Chang MD , Hsiu-Chuan Wu MD, Ph.D , Kuo-Hsuan Chang MD, Ph.D","doi":"10.1016/j.jstrokecerebrovasdis.2024.108038","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>While an increased incidence of intracerebral hemorrhage (ICH) has been reported in patients with nephrotic syndrome (NS), comprehensive understanding of the characteristics of ICH in this population remains elusive. This study explored the clinical features of ICH in a larger cohort of NS patients.</div></div><div><h3>Methods</h3><div>To compare the clinical characteristics of ICH in patients with and without NS, we conducted a multi-institutional retrospective cohort study using the data from Chang Gung Research Database of Taiwan from January 1, 2001, to December 31, 2017.</div></div><div><h3>Results</h3><div>This study enrolled a total of 120 ICH patients with NS, and 271 ICH patients without NS. Patients with NS had a longer average length of stay in the acute medicine ward (17.7 ± 15.9 days vs 14.4 ±13.3 days, <em>P</em> = 0.047) and higher incidence of urinary tract infection (20.0% vs 10.0%, <em>P</em> = 0.006), gastrointestinal bleeding (16.7% vs 4.8%, <em>P</em> < 0.001), and pulmonary edema (4.2% vs 0%, <em>P</em> = 0.003) compared to those without ICH. Furthermore, the risk of 30-day dependent outcome (modified Rankin Scale score≧3) was significantly higher in ICH patients with NS compared to those without NS (Odds ratio 3.43, 95% confidence interval 1.49 to 7.91, <em>P</em> = 0.004). However, the 30-day mortality rate was similar between the NS patients and the control group.</div></div><div><h3>Conclusions</h3><div>NS is associated with a significantly increased risk of functional dependence following ICH, highlighting the critical need for tailored intensive treatment and rehabilitation specifically for this patient population.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"33 12","pages":"Article 108038"},"PeriodicalIF":2.0000,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Stroke & Cerebrovascular Diseases","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1052305724004828","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NEUROSCIENCES","Score":null,"Total":0}

引用次数: 0

Abstract

Background

While an increased incidence of intracerebral hemorrhage (ICH) has been reported in patients with nephrotic syndrome (NS), comprehensive understanding of the characteristics of ICH in this population remains elusive. This study explored the clinical features of ICH in a larger cohort of NS patients.

Methods

To compare the clinical characteristics of ICH in patients with and without NS, we conducted a multi-institutional retrospective cohort study using the data from Chang Gung Research Database of Taiwan from January 1, 2001, to December 31, 2017.

Results

This study enrolled a total of 120 ICH patients with NS, and 271 ICH patients without NS. Patients with NS had a longer average length of stay in the acute medicine ward (17.7 ± 15.9 days vs 14.4 ±13.3 days, P = 0.047) and higher incidence of urinary tract infection (20.0% vs 10.0%, P = 0.006), gastrointestinal bleeding (16.7% vs 4.8%, P < 0.001), and pulmonary edema (4.2% vs 0%, P = 0.003) compared to those without ICH. Furthermore, the risk of 30-day dependent outcome (modified Rankin Scale score≧3) was significantly higher in ICH patients with NS compared to those without NS (Odds ratio 3.43, 95% confidence interval 1.49 to 7.91, P = 0.004). However, the 30-day mortality rate was similar between the NS patients and the control group.

Conclusions

NS is associated with a significantly increased risk of functional dependence following ICH, highlighting the critical need for tailored intensive treatment and rehabilitation specifically for this patient population.

查看原文本刊更多论文

肾病综合征患者脑内出血的临床特征和功能依赖性风险。

背景：虽然有报道称肾病综合征（NS）患者脑内出血（ICH）的发病率增高，但人们对这一人群中ICH的特征仍缺乏全面的了解。本研究探讨了更多肾病综合征患者的 ICH 临床特征：为了比较NS患者和非NS患者ICH的临床特征，我们利用台湾长庚研究数据库2001年1月1日至2017年12月31日的数据进行了一项多机构回顾性队列研究：这项研究共纳入了120名患有NS的ICH患者和271名不患有NS的ICH患者。与非ICH患者相比，NS患者在急诊病房的平均住院时间更长（17.7 ± 15.9天 vs 14.4 ± 13.3天，P = 0.047），尿路感染（20.0% vs 10.0%，P = 0.006）、消化道出血（16.7% vs 4.8%，P < 0.001）和肺水肿（4.2% vs 0%，P = 0.003）的发生率更高。此外，与无 NS 的 ICH 患者相比，有 NS 的 ICH 患者出现 30 天依赖性结果（修改后的 Rankin 量表评分≧3）的风险明显更高（Odds ratio 3.43，95% 置信区间 1.49 至 7.91，P = 0.004）。然而，NS患者和对照组的30天死亡率相似：结论：NS 与 ICH 后功能依赖性风险的明显增加有关，这突出表明迫切需要专门针对这一患者群体进行量身定制的强化治疗和康复。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.