改良急诊脑出血分级量表对自发性脑出血患者30天病死率的预测作用被引量：13

Role of mEDICH grading scale in predicting 30-day mortality of patients with spontaneous intracerebral hemorrhage

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摘要目的判断改良急诊脑出血分级量表（mEDICH）能否准确预测自发性脑出血（SICH）患者30d的病死率。方法回顾性分析我院神经内科急诊收治的SICH患者128例的临床资料,分为存活组86例,死亡组42例,同时采集2组mEDICH评分的各项资料以及发病后30d病死率,绘制ROC曲线,评估mEDICH分值对30d病死率的预测价值。结果存活组口服抗血小板药物比例低于死亡组（10.5%vs 26.2%,P=0.021）,mEDICH评分0~3分比例高于死亡组（84.9%vs 26.2%,P=0.000）,4~8分比例低于死亡组（15.1%vs 73.8%,P=0.000）。mEDICH最佳界值为3.5分时,敏感性73.8%,特异性84.9%,ROC曲线下面积0.846（95%CI：0.771~0.921,P=0.000）。结论 mEDICH可以较准确地预测SICH患者30d病死率,mEDICH评分〉3分时病死率明显增加。 Objective To study whether mEDICH grading scale can accurately predict the 30-day mortality of patients with spontaneous intracerebral hemorrhage（SICH）.Methods Clinical data of 128 SICH patients admitted to our department from January 2014 to December 2015 were retrospectively analyzed.The patients were divided into survival group（n=86）and death group（n=42）.The GCS,hematoma size,hematoma site,hemorrhage involving cerebral ventricle and subtentorium,INR and 30-day mortality were recorded.ROC curve was plotted for assessing the role of mEDICH grading scale in predicting the 30-day mortality of SICH patients.Results The ratio of administered oral antiplatelet drugs was significantly lower in survival group than in death group（10.5%vs 26.2%,P=0.021）.The ratio of 0-3mEDICH grading scale scores was significantly higher whereas that of 4-8 mEDICH grading scale scores was significantly lower in survival group than in death group（84.9% vs 26.2%,15.1% vs 73.8%,P=0.000）.The sensitivity of mEDICH grading scale score was 73.8%,the specificity of mEDICH grading scale score was84.9%,and the area under the ROC curve was 0.846 when its best cut-off value was 3.5（95%CI：0.771-0.921,P=0.000）.Conclusion The mEDICH grading scale can accurately predict the 30-day mortality of SICH patients.The 30-day mortality is significantly higher when the mEDICH grading cale score is〉3.

作者张运周高冉高岱佺刘刚

机构地区首都医科大学宣武医院神经内科

出处《中华老年心脑血管病杂志》 CAS 2016年第6期564-566,共3页 Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

关键词脑出血死亡率格拉斯哥昏迷量表血肿 ROC曲线 cerebral hemorrhage mortality Glasgow coma scale hematoma ROC curve

分类号 R743.34 [医药卫生—神经病学与精神病学]

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