自发小脑出血患者的长期结果:国际队列研究
Jasper R Senff1,2,3,4,5, Sanjula D Singh1,2,6,3,4,5, Marco Pasi6,7,8
1Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands (J.R.S., S.D.S., J.P.J.D., J.T., G.J.E.R., H.B.B.).
Stroke
|March 15, 2024
概括
在第一次小脑出血中幸存下来的患者面临着长期预后不佳和高风险的复发性血管事件,类似于 supratentorial出血幸存者.
科学领域:
- 神经学 神经学
- 心血管研究研究心血管研究
- 公共卫生 公共卫生
背景情况:
- 小脑中的自发性脑内出血 (ICH) 与短期的不良结果有关.
- 有限的数据存在于长期病例死亡率和血管事件的复发后大脑小脑ICH.
- 了解长期风险对于患者管理和二次预防策略至关重要.
研究的目的:
- 评估第一次自发小脑ICH发生后的长期病例死亡率.
- 为了确定最初大脑ICH幸存的患者血管事件的复发率.
- 提供关于小脑ICH幸存者的长期预后和二次预防需求的见解.
主要方法:
- 国际队列研究包括来自10家医院的405名患者 (1997-2017).
- 包括年龄≥18岁的患者,首次发生自发小脑ICH,活着出院.
- 收集关于长期病例死亡率和复发性血管事件 (ICH,缺血性中风,心肌梗塞,主要血管手术) 的数据,用于生存分析.
主要成果:
- 平均存活时间为67个月,10年累积存活率为34%.
- 在拥有事件数据的347名患者中,78人经历了92次血管事件.
- 任何血管事件的10年累积风险为47%,出现复发性ICH (8.9%),缺血性中风 (11%),心肌梗塞 (3.7%) 和主要血管手术 (1.4%).
结论:
- 小脑ICH幸存者的长期预后很差,与 supratentorial ICH幸存者相比.
- 存在重复性血管事件的重大风险,需要进一步确定风险.
- 在小脑ICH患者中进行二次预防的随机对照试验是合理的.
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