破裂但未经治疗的内动脉瘤的自然过程:多中心2年随访研究
Yifan Yang1, Bangyue Wang1, Xinbo Ge2
1Department of Neurosurgery, Tianjin Medical University General Hospital, China (Y.Y., B.W., C.P., Y.Z., J.L., J.Z., X.Y.).
Stroke
|June 12, 2023
概括
在中国患者中观察到高死亡率,这些患者未经治疗的内动脉瘤破裂. 糟糕的亨特和赫斯成绩,意识丧失和大动脉瘤大小预测了两年内的死亡率.
科学领域:
- 神经学 神经学
- 神经外科 神经外科
- 公共卫生 公共卫生
背景情况:
- 关于未经治疗的破裂内动脉瘤的数据有限,特别是在中国人群中.
- 之前的研究受到了设计局限性和不准确的患者数据的影响.
- 对于这个人口群体,多中心注册表的研究很少.
研究的目的:
- 确定中国一组未经治疗的破裂内动脉瘤患者的2年死亡率.
- 为了确定这个患者群体中死亡率的预测因素.
- 分析治疗决策和拒绝率.
主要方法:
- 使用了中国多中心脑动脉瘤数据库 (前性,观察性).
- 包括来自12个三级医疗中心的患者 (2017-2020年).
- 使用卡普兰-梅尔生存分析和Cox回归来预测死亡率.
主要成果:
- 在941名患者中,整体2年死亡率为68.1%.
- 死亡率预测因素包括亨特和赫斯3-5年级,意识丧失和动脉瘤大小≥5毫米.
- 很大一部分 (42.6%) 拒绝接受手术治疗.
结论:
- 神经学等级差,意识丧失和动脉瘤大小与高死亡率有关.
- 观察到高的治疗拒绝率.
- 调查结果为医疗保险,医生与患者的沟通以及公共卫生教育提供了信息.
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