体温与脑出血病死率关系的研究

Influence of admission temperature on mortality in intracerebral hemorrhage patients.

目的 回顾性调查研究急性脑出血病人入院时的体温对院内病死率的预测性作用。方法 对1979年1月1日至2000年6月30日收入病房的1305例急性脑出血病人,应用多项逐步Logistic 回归分析了体温及其他因素对院内病死率的影响。结果 1305例病人中院内死亡204例,病死率15.6％,高体温组病人较低体温及正常体温组病人的病死率高,高体温的院内病死率对正常体温的比值比(OR)为2.027,其他影响脑出血院内病死率结局的因素有昏迷、高血糖、白细胞增高、上消化道出血、肾损害、肺炎、尿失禁(OR>1);而当这些因素被控制时体温仍与脑出血院内病死率增加有关(OR=1.818)。结论 入院时高体温与脑出血院内病死率升高独立相关。

Objective To investigate the prognostic role of admission body temperature on in-hospital mortality in a retrospective cohort study of patients with acute intracerebral hemorrhage. Methods A retrospective cohort of 1305 patients with acute intracerebral hemorrhage, admitted to our hospital between January 1, 1979 and June 30, 2000, was studied. The relationship between admission temperature and in-hospital mortality was evaluated. Body temperature on admission was classified as hypothermia ( ≤36.5℃ ) , normothermia ( > 36.5℃ and ≤37.5℃ ) , and hyperthermia ( > 37.5℃ ) . Other factors such as age, sex, stroke severity, infection, white blood cell count (wbc) , diabetes, hypertension, stroke history, were included in the logistic regression model. Forward logistic regression analysis was performed. Results The in-hospital mortality of those patients was 15.6% (204/ 1 305). Mortality was higher among patients with hyperthermia than patients with hypothermia and normothermia. The odds ratio for in-hospital mortality in hyperthermic versus normothermic patients was 2.027(95%CI, 1.323 to 3.107) . Other factors that play prognostic roles were coma, hyperglycemia, wbc > 10.0 ×109/L, upper gastrointestinal hemorrhage, renal lesion, pneumonia and urinary incontinence (OR> 1). High temperature was still a prognostic factor when other factors were controled (OR= 1.818). Conclusions Admission body temperature was associated with in-hospital mortality in intracerebral hemorrhage patients independently .