医学
脑出血
改良兰金量表
优势比
置信区间
冲程(发动机)
队列
前瞻性队列研究
内科学
急诊医学
儿科
缺血性中风
蛛网膜下腔出血
机械工程
工程类
缺血
作者
Lan Deng,Zuo‐Qiao Li,Wen‐Song Yang,Rui Li,Xin‐Ni Lv,Yu-Lun Li,Zi‐Jie Wang,Xiao Hu,Libo Zhao,Fajin Lv,Shengtao Yao,Fuliang Cao,Peng Xie,Qi Li
出处
期刊:Cerebrovascular Diseases
[S. Karger AG]
日期:2022-12-12
卷期号:52 (4): 471-479
被引量:2
摘要
The objective of this study was to define prehospital ultra-early neurological deterioration (UND) and to investigate the association with functional outcomes in patients with intracerebral hemorrhage (ICH).We conducted a prospective cohort study of consecutive acute ICH patients. The stroke severity at onset and hospital admission was assessed using the Chongqing Stroke Scale (CQSS), and prehospital UND was defined as a CQSS increase of ≥2 points between symptoms onset and admission. Early neurological deterioration (END) was defined as the increase of ≥4 points in NIHSS score within the first 24 h after admission. Poor outcome was defined as a modified Rankin Scale (mRS) of 4-6 at 3 months.Prehospital UND occurred in 29 of 169 patients (17.2%). Patients with prehospital UND had a median admission NIHSS score of 17.0 as opposed to those without prehospital UND with a median NIHSS score of 8.5. There were three patterns of neurological deterioration: prehospital UND only in 21 of 169 patients (12.4%), END but without prehospital UND in 20 of 169 patients (11.8%), and continuous neurological deterioration in both phases in 8 patients (4.7%). Prehospital UND was associated with worse 3-month outcomes (median mRS score, 4.0 vs. 2.0, p = 0.002). After adjusting for age, time from onset to admission, END, and systolic blood pressure, prehospital UND was an independent predictor of poor outcome (odds ratio [OR] 3.27, 95% confidence interval [CI] 1.26-8.48, p = 0.015).Prehospital UND occurs in approximately 1 in 7 patients between symptom onset and admission and is associated with poor functional outcome in patients with ICH. Further research is needed to investigate the prehospital UND in the prehospital phase in the triage of patients with ICH.
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