D-dimer may predict poor outcomes in patients with aneurysmal subarachnoid hemorrhage: a retrospective study

Serum biomarkers may play a reliable role in predicting the outcomes of patients with aneurysmal subarachnoid hemorrhage. This study retrospectively analyzed the relationship between serum biomarkers on admission and outcomes in patients with aneurysmal subarachnoid hemorrhage. We recruited 146 patients with aneurysmal subarachnoid hemorrhage who were treated in Renmin Hospital of Wuhan University of China between 1 May 2014 and 30 March 2016. There were 57 males and 89 females included and average age of included patients was 57.03 years old. Serum samples were taken immediately on admission（within 48 hours after initial hemorrhage） and the levels of serum biomarkers were detected. Baseline information, complications, and outcomes at 6 months were recorded. Univariate and multivariate logistic regression analyses were used to explore the relationship between biomarkers and clinical outcomes. Receiver operating characteristic curves were obtained to investigate the possibility of the biomarkers predicting prognosis. Of the 146 patients, 102 patients achieved good outcomes and 44 patients had poor outcomes. Univariate and multivariate analyses showed that high World Federation of Neurosurgical Societies grade, high serum D-dimer levels, and high neurological complications were significantly associated with poor outcomes. Receiver operating characteristic curves verified that D-dimer levels were associated with poor outcomes. D-dimer levels strongly correlated with neurological complications. In conclusion, we suggest that D-dimer levels are a good independent prognostic factor for poor outcomes in patients with aneurysmal subarachnoid hemorrhage.

Logistic regression analysis on therapeutic effect of acupuncture on neck pain caused by cervical spondylosis and factors influencing therapeutic effect

Objective To explore the main factors influencing the therapeutic effect of acupuncture on neck pain caused by cervical spondylosis, so as to provide references for further increasing the therapeutic effect of acupuncture. Methods One hundred and six cases were randomly divided into an observation group and a control group, 53 cases in each group. The observation group was treated with routine acupuncture at Dazhui （大椎GV 14）, Jingbailao （颈百劳 EX-HN 15） and Jianzhongshu （肩中俞 SI 15）; and the control group was treated with sham acupuncture at 1 cm lateral to Jingbailao （颈百劳 EX-HN 15） and Jianzhongshu （肩中俞 SI 15）. The needles were retained for 20 min in the two groups and infrared radiation was used for adjuvant treatment in this period. Northwick Park Neck Pain Questionnaire （NPQ） was used to assess the patients＇ quality of life before and after the treatment and compare the therapeutic effect between two groups. The potential influential factors were analyzed by Logistic regression. Results The effective rate was 75.5% in the observation group and 52.8% in the control group with a significant difference between the two groups （P〈0.05）. The Logistic regression analysis indicated that the therapeutic effect in the observation group was superior to that of the control group （OR=2.670）, and both the attack frequency and duration of the neck pain would influence the therapeutic effect （OR=1.055 and OR=2.446）. Conclusion Acupuncture has a preferable therapeutic effect on neck pain caused by cervical spondylosis, and patient＇s clinical history about attack frequency and duration of neck pain are factors influencing clinical therapeutic effect.