吸烟作为一次性脑内出血中血瘤扩张的危险因素:来自随机临床试验的分析
Alexander J Schupper1, Mirhojjat Khorasanizadeh1, Christina P Rossitto1
1Department of Neurosurgery Mount Sinai Health System New York NY.
Journal of the American Heart Association
|July 31, 2023
概括
当前吸烟者和前吸烟者在脑内出血后经历了更大的血瘤扩张. 吸烟是扩张的独立预测因素,但没有显著影响90天死亡或残疾率.
科学领域:
- 神经学 神经学
- 心血管医学 心血管医学
- 公共卫生 公共卫生
背景情况:
- 吸烟是已知的中风风险因素之一.
- 主要脑内出血 (ICH) 是一种严重的中风形式.
- 了解影响ICH结果的因素对于患者管理至关重要.
研究的目的:
- 评估吸烟状态对ICH患者血液瘤扩张的影响.
- 评估吸烟和临床结果 (死亡和残疾) 在ICH后90天之间的关系.
主要方法:
- 在急性脑出血 (ATACH) -2 试验中对抗高血压治疗进行了后期分析.
- 根据吸烟状况 (目前,前,从未吸烟者) 进行人口统计特征,血瘤扩张和临床结果的比较.
- 使用多变量分析来调整潜在的混因素.
主要成果:
- 曾经吸烟者 (现任和前任) 较年轻,更有可能是男性,并患有较高的甲状腺和腹腔内出血率.
- 吸烟者在24小时内表现出明显更高的血瘤扩张率 (调整后的RR,1.46 [1.08-1.96]).
- 在吸烟者和非吸烟者之间没有观察到90天死亡或残疾率的显著差异.
结论:
- 吸烟是主要脑内出血患者血液瘤扩张的独立预测因子.
- 虽然吸烟增加了血液瘤的扩张,但它并没有显著影响这项研究队列的长期死亡率或残疾.
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