自发性脑室上出血患者高水平 D-二聚体与预后之间的关系：一项回顾性研究和双重验证。

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2024-11-10 DOI:10.1016/j.jstrokecerebrovasdis.2024.108129

ZhenKun Xiao PhD , Xingyu Mao MS , Bing Wang PhD , YiBo Yang MS , Jie Niu MD , Yong-Mei Yang PhD , Ai-Hua Liu PhD , Yong-Hong Duan MD

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引用次数: 0

摘要

研究目的方法：557 例自发性幕上脑室内出血患者接受了手术治疗，包括开颅手术清除血肿和穿刺引流。根据改良Rankin量表（mRS）的分叉，患者被分为两个亚组：预后良好组（mRS评分0-2分）和预后不良组（mRS评分3-5分）。在入院 24 小时内测量 D-二聚体水平，监测直至出院，并按四分位数（Q1-Q4）分组。我们收集并计算了不同时期的 D-二聚体水平：(1) 入院时（手术前）；(2) 手术后的平均水平；(3) 住院期间的平均水平；(4) 住院期间的峰值水平。我们采用了两种方法进行验证，第一种是使用传统的多因素 Logsitic 回归方程，第二种是选择基线临床、实验室和其他变量，通过多变量 Logistic 回归构建预后模型：统计结果表明，年龄、入院时格拉斯哥昏迷评分（GCS）、D-二聚体水平高和出血量在统计学上存在显著差异。根据初始年龄、GCS 和 D-二聚体建立的预测模型显示出良好的判别能力结论：D-二聚体是一个独立的风险因素：D-二聚体是导致 SSTICH 患者术后预后不良的独立危险因素，根据 D-二聚体建立的预后模型可预测 SSTICH 患者术后预后不良的情况。该模型需要在其他机构进行的更大规模研究中得到验证。

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Relationship between high levels of D-dimer and prognosis in patients with spontaneous supratentorial cerebral haemorrhage: A retrospective study and double validation

Objective

The aim of this study was to investigate the correlation between D-Dimer and unfavorable outcome after surgery for spontaneous supratentorial intracerebral hemorrhage(SSICH)

Methods

A total of 557 patients with spontaneous supratentorial intracerebral hemorrhage underwent surgical treatment, which included craniotomy evacuation of hematoma and puncture and drainage. Based on the modified Rankin Scale (mRS) bifurcation, the patients were divided into two subgroups: favorable outcome (mRS score 0–2) and unfavorable outcome (mRS score 3-5). D-dimer levels were measured within 24 h of admission, monitored until discharge, and grouped by quartiles (Q1-Q4). We collected and calculated D-dimer levels at different periods of time: (1) at admission (pre-surgery); (2) average post-surgery level; (3) average level during hospitalization; and (4) peak level during hospitalization. Two methods were used for validation, the first using a traditional multifactorial Logsitic regression equation, and the second where we chose baseline clinical, laboratory, and other variables and constructed a prognostic model through multivariate logistic regression.

Results

Statistical results showed statistically significant differences in age, Glasgow Coma Score (GCS) on admission, high levels of D-dimer, and bleeding. Predictive models developed on the basis of initial age, GCS, and D-Dimer showed good discriminatory power

Conclusions

D-dimer is an independent risk factor for the development of poor postoperative prognosis in patients with SSTICH, and a prognostic model developed on the basis of D-Dimer predicts the development of poor postoperative prognosis in patients with SSTICH. The model needs to be validated in larger studies conducted at other institutions.

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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.