自发性脑出血患者流行病学特点与死亡影响因素分析

Analysis of epidemiological characteristics and mortality factors of patients with spontaneous intracerebral hemorrhage

目的探讨自发性脑出血(SICH)患者的流行病学特点,并分析其死亡的影响因素。方法回顾性分析解放军联勤保障部队第九〇九医院神经外科自2015年1月至2021年12月收治的2765例SICH患者的流行病学资料,分析流行病学特征,并根据治疗结局将患者分为存活组(2497例)和死亡组(268例),采用单因素和Logistic多因素回归分析死亡的影响因素。结果2765例患者中,男女比例2.54∶1,50岁以上患者是20~50岁患者的2.48倍;第四季度发病率分别是一、二、三季度的1.85、1.88、1.61倍;凌晨发病率分别是上午、下午和晚上的1.69、1.65、1.39倍。单因素分析和Logistic多因素分析结果显示沿海地区、脑出血家族史、入院GCS评分、脑干出血、血肿体积、中线移位≥5 mm是预后的独立影响因素。结论本地区SICH患者中男性比例高于女性,第四季度和凌晨发病率较高,重视沿海地区和脑出血家族史人员,结合入院GCS评分、出血体积和中线移位情况可以判断患者的预后情况。

ObjectiveTo investigate the epidemiological characteristics of patients with spontaneous intracerebral hemorrhage(SICH)and to analyze the mortality factors.MethodsEpidemiological data of 2765 patients of SICH admitted to Neurosurgery Department of the 909thHospital of the Joint Service Support Force from January 2015 to December 2021 were retrospectively analyzed.The epidemiological characteristics were analyzed.According to the treatment outcome,the patients were divided into survival group(n=2497)and death group(n=268).Univariate and Logistic multivariate analysis were used to analyze the influencing factors of death.ResultsAmong the 2765 patients,the male to female ratio is 2.54 to 1.The number of patients aged 50 or older was 2.48 times than that of those aged 20 to 50.The incidence rate in the fourth quarter was 1.85,1.88 and 1.61 times higher than that in the first,second and third quarters.The incidence rate of early morning was 1.69,1.65 and 1.39 times higher than that of morning,afternoon and evening.Univariate analysis and Logistic multivariate analysis showed that coastal area,family history of intracerebral hemorrhage,admission GCS score,brainstem hemorrhage,hematoma volume,midline displacement≥5 mm were independent prognostic factors.ConclusionIn this region,the proportion of patients with spontaneous intracerebral hemorrhage is higher in males than in females,and the incidence rate is higher in the fourth quarter and early morning.The prognosis of the patients can be determined by paying attention to the coastal areas and family history of intracerebral hemorrhage,combined with the admission GCS score,hemorrhage volume and midline displacement.