Junhua Yang, Sihui Wang, Xiangtian Ji, Yu Sun, Jingyu Feng, Bin Liu, Jun Yang
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引用次数: 0
Abstract
Background and purpose: Spontaneous intracerebral hemorrhage (sICH) significantly affects patient outcomes. Diabetes mellitus (DM) is a common comorbidity associated with sICH; however, the influence of DM on hematoma expansion (HE) and clinical prognosis in sICH patients remains a subject of debate.
Methods: This multicenter retrospective study included sICH patients who visited the neurosurgery departments of eight hospitals between 1 January 2015 and 31 May 2021. These patients were followed up for 6 months post-sICH and divided into two groups: those with type 2 DM (DM group) and those with no diabetes mellitus (nDM group). The chi-square test, Mann-Whitney U test, and multivariate logistic regression analysis were employed to evaluate the impact of DM on HE and patient outcomes.
Results: A total of 1,453 patients were admitted to the eight hospitals between 1 January 2015 and 31 May 2021. A total of 1,134 sICH patients were ultimately included in this study for further analysis, based on the inclusion and exclusion criteria. Of these, 182 (16.0%) patients were assigned to the DM group, while 952 (84.0%) patients were assigned to the nDM group. In the intergroup comparison, significant differences were observed in terms of gender, age, smoking, hypertension, coronary heart disease, antiplatelet therapy, ventricular hematoma, and heterogeneous hematoma density. After adjusting for the above confounders, DM was found to significantly increase the incidence of HE (3.552, 95% CI: 2.342-5.387, p = 0.000). Similarly, DM significantly increased all-cause mortality at 1 month (1.965, 95% CI: 1.006-3.840, p = 0.048), 3 months (1.980, 95% CI: 1.071-3.662, p = 0.029), and 6 months (1.776, 95% CI: 1.034-3.050, p = 0.038) in sICH patients. However, DM did not worsen functional prognosis in patients with sICH at 1 month (1.363, 95% CI: 0.909-2.043, p = 0.134), 3 months (1.124, 95% CI: 0.746-1.692, p = 0.577), and 6 months (1.177, 95% CI: 0.789-1.754, p = 0.425), after adjusting for confounding factors.
Conclusion: DM is a risk factor for HE and all-cause mortality at 1, 3, and 6 months post-sICH. However, DM does not significantly worsen the functional prognosis of sICH patients at 1, 3, and 6 months.
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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