早期锥颅抽吸血肿治疗幕上高血压性脑出血患者死亡概率的预测研究

目的探讨早期锥颅抽吸血肿治疗幕上高血压性脑出血患者30 d死亡的危险因素,建立早期锥颅抽吸血肿治疗幕上高血压性脑出血患者死亡的概率预测模型.方法回顾性分析近3年来收治的56例早期锥颅抽吸血肿治疗幕上高血压性脑出血的病例,对影响患者术后生存的危险因素进行两分类Logstic回归分析.结果56例患者,术后30 d死亡率为35.7%.两分类Logstic回归分析显示意识水平、出血量和性别是影响早期锥颅抽吸血肿治疗幕上高血压性脑出血患者术后30 d死亡的危险因素(P＜0.05),其中意识水平(P＜0.05)和出血量(P＜0.05)是危险暴露因子,而患者性别则是保护因子(P＜0.05).早期锥颅抽吸血肿治疗幕上高血压性脑出血患者术后30 d死亡概率的简易预测模型为Logt P=-5.789+1.441X意识+0.053X出血量-2.0480X性别.应用建立的预测模型进行组内回代检验,该模型灵敏度为94.4%.结论意识水平、出血量和性别是影响早期锥颅抽吸血肿治疗幕上高血压性脑出血患者术后30 d死亡的危险因素,由此建立术后30 d死亡概率预测模型对临床具有一定的指导意义.

PREDICATION OF MORTALITY FOR PATIENTS WITH SUPRATENTORIAL HYPERTENSIVE INTRACEREBRAL HEMORRHAGE TREATED BY EARLY STEREOTAXIC ASPIRATION

Objective: To explore the risk factors that may result in death within 30 days in patients with supratentorial hypertensive intracerebral hemorrhage treated by stereotactic aspiration and to develop a predictive model of mortality assessment. Method:The historical data for 56 patients with supratentorial hypertensive intracerebral hemorrhage treated by stereotactic aspiration were reviewed. Risk factors were determined by binary logistic regression analysis. Results: The 30 day mortality for the studied group was 35.7%. Binary logistic regression analysis showed that level of consciousness, volume of hemorrhage and sex were correlated with 30 day mortality (P<0.05). While consciousness level (OR=12.411, P<0.05) and hemorrhage volume served as risk exposure predicators, the sex of patient (OR = 0.002, P<0.05) was a protective predicator of 30 day mortality. A simple predicative model can be established by using the three predicators: LogitP=-5.789 + 1.441X + 0.053X - 2.0480X (1st X consciousness level,2nd X hemorrhage volume and 3rd X sex). A sensitivity of 94.4% was obtained when the model was used for testing the studied group.Conclusion:The level of consciousness, volume of hemorrhage and sex are risk factors for 30 day death in patients with supratentorial hypertensive intracerebral hemorrhage treated by stereotactic aspiration. A model based on the study has clinical significance.