CT环池分级联合颞角最大宽度对重型脑室出血患者30d死亡率预测价值

Predictive value of cisterna ambiens classification of CT imaging combined with maximum width of the temporal horn on 30-day mortality in patients with severe intraventricular hemorrhage

目的探讨CT环池分级联合颞角最大宽度对重型脑室出血(SIVH)患者30d死亡率的意义。方法回顾分析2017年12月至2021年1月我院神经外科收治的45例行脑室外引流治疗的SIVH患者临床资料。根据患者入院30d内是否死亡分为死亡组(17例)和存活组(28例)两组。通过单因素和多因素Logistic回归分析,揭示患者30d内死亡的独立危险因素,采用受试者特征工作(ROC)曲线分析独立危险因素对30d死亡率的预测能力。结果通过多因素Logistic回归分析,CT环池评分(OR=0.287,95%CI:0.124~0.664,P=0.004)、颞角最大宽度(OR=1.208,95%CI:1.011~1.443,P=0.037)与患者30d死亡结局独立相关,二者联合预测30d死亡率的曲线下面积(AUC)为0.866(95%CI:0.731~0.949,P<0.001),敏感度82.14%,特异度64.71%。结论CT环池分级联合颞角最大宽度对SIVH患者30d死亡率具有较好的预测价值。

Objective To investigate the significance of cisterna ambiens classification of CT imaging combined with maximum width of the temporal horn on 30-day mortality in patients with severe intraventricular hemorrhage(SIVH).Methods Clinical data of 45patients with SIVH treated with external ventricular drainage(EVD)admitted to the hospital from December2017to January 2021were retrospectively analyzed.According to whether the patients died within30days after admission,they were divided into two groups:the death group(17cases)and the survival group(28cases).By univariate and multivariate binary Logistic regression analysis,independent risk factors were detected.The receiver operating characteristic(ROC)curve was applied to analyze the predictive value of independent risk factors for 30-day mortality.Results Multivariate binary logistic regression analysis showed that cisterna ambiens classification of CT imaging(OR=0.287,95%CI:0.124~0.664,P=0.004),maximum width of the temporal horn(OR=1.208,95%CI:1.011~1.443,P=0.037)were independently associated with death within 30days betweenthe death group and the survival group.The area under the curve(AUC)of the above risk factors combined to predict 30-day mortality was 0.866(95%CI:0.731~0.949,P<0.001).The sensitivity was 82.14%and the specificity was 64.71%.Conclusion Cisterna ambiens classification of CT imaging combined with maximum width of the temporal horn have great predictive value on 30-day mortality in patients with SIVH.