基底节出血30天死亡概率的预测研究

Predictors of 30-day mortality after intracerebral basal ganglia hemorrhage

目的 探讨基底节出血 30天死亡的危险因素 ,建立基底节出血 30天死亡的概率预测模型。方法 回顾性分析我院近 5年来病房收治的 2 90例基底节出血病例 ,对影响基底节出血死亡的危险因素进行多元Logistic回归分析。结果 2 90例基底节出血病人 ,30天病死率为 13.4%。单因素 χ2 检验表明 ,意识障碍、脑出血破入脑室、大量出血、伴发糖尿病、缺血性心脏病、消化道出血等 6个因素为基底节出血 30天死亡的危险因素 (P <0 .0 5 )。多因素Logistic回归分析发现 ,仅有意识水平 (OR =6 .949,P <0 .0 1)和消化道出血 (OR =2 9.480 ,P <0 .0 1)是基底节出血 30天死亡的独立预测因子。基底节出血 30天死亡的概率预测模型为LogitP =- 5 .15 0 +2 .2 83X意识 +3.6 37X消化道出血 ,该模型对基底节出血 30天死亡或生存预测总的正确率为 92 .8%。结论 意识水平和伴有消化道出血是影响基底节出血 30天死亡的最重要危险因素 ,由此建立的基底节出血 30天死亡概率预测模型对临床具有一定的指导意义。

Objective To determine the most important predictors of 30 day mortality in patients with intracerebral basal ganglia hemorrhage and to develop a predictive model to estimate 30 day mortality. Methods The medical records and CT scans of 290 in patients with intracerebral basal ganglia hemorrhage were retrospectively reviewed. Independent predictors of 30 day mortality were determined using univariate and multivariate statistical analyses. Results The 30 day mortality for the 290 cases of intracerebral basal ganglia hemorrhage was 13.4% . Univariate analysis indicated initial level of consciousness, intraventricular spread of the hemorrhage, hemorrhage size, treatment, concomitant gastro intestinal bleeding and diabetes mellitus were significantly correlated with 30 day mortality ( P < 0.01 ). But multivariate logistic regression analyse showed that initial level of consciousness ( OR = 6.949 , P < 0.01 ) and concomitant gastro intestinal bleeding ( OR = 29.480 , P < 0.01 ) were significant independent predictors of 30 day mortality. Using these two categories variables, the resulting model can predict 30 day death or survival with an overall accuracy rate of 92.8% . Conclusion Initial level of consciousness, in combination with concomitant gastro intestinal bleeding, was a powerful and ease to use predictor of 30 day mortality in patients with intracerebral basal ganglia hemorrhage.