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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Comparison of outcomes after intracerebral hemorrhage and ischemic stroke.
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Comparison of outcomes after intracerebral hemorrhage and ischemic stroke.

机译：脑出血和缺血性中风后的结局比较。

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BACKGROUND: Intracerebral hemorrhage (ICH) is associated with a greater average initial stroke severity, higher mortality, and poorer long-term neurologic outcomes than ischemic stroke. The purpose of this study was to determine whether the poorer prognosis of ICH is independent of initial stroke severity. METHODS: We analyzed data from the Glycine Antagonist in Neuroprotection (GAIN) Americas trial, in which 1604 non-obtunded patients with acute stroke were treated within 6 hours of symptom onset irrespective of hemorrhagic (N = 237) versus ischemic (N = 1367) subtype. Multiple logistic regression analysis was performed to evaluate predictors of mortality and neurologic outcome (modified Rankin scale [mRS] score of 0-1 v 2-6 at 3 months) adjusting for baseline National Institutes of Health Stroke Scale score, stroke risk factors, clinical and demographic characteristics, and gavestinel treatment group. Multiple linear regression techniques were used to assess the impact of various predictors on the full mRS score at 3 months. RESULTS: ICH significantly increased the odds of a poor neurologic outcome (odds ratio 1.94, 95% confidence interval 1.23-3.06) and was independently associated with a mean 0.25-point increase in the 3-month mRS score (P = .04). ICH had no effect on mortality compared with ischemic stroke (odds ratio 1.01, 95% confidence interval .68-1.49) after adjusting for initial stroke severity (National Institutes of Health Stroke Scale score) and other baseline characteristics. CONCLUSIONS: Among conscious stroke patients, ICH is an independent predictor of poor neurologic outcome, nearly doubling the odds of long-term disability. However, ICH is not associated with higher mortality compared with ischemic stroke after adjusting for initial stroke severity and other baseline characteristics.
机译：背景：与缺血性中风相比，脑出血（ICH）与平均中风的严重程度更高，死亡率更高，长期神经系统预后较差有关。这项研究的目的是确定ICH较差的预后是否与初始卒中严重性无关。方法：我们分析了美国神经保护（GAIN）试验中的甘氨酸拮抗剂的数据，该试验在症状发作后6小时内对1604名非阻塞性急性卒中患者进行了治疗，而不论出血性（N = 237）与缺血性（N = 1367）亚型。进行了多元逻辑回归分析，以评估死亡率和神经系统结果的预测因子（3个月时改良的Rankin量表[mRS]评分为0-1 v 2-6），以基线为基础的美国国立卫生研究院卒中量表评分，卒中危险因素，临床和人口统计学特征，并进行木槌治疗。多元线性回归技术用于评估各种预测因素对3个月时完整mRS评分的影响。结果：ICH显着增加了神经系统预后不良的几率（赔率1.94，95％置信区间1.23-3.06），并且与3个月mRS评分的平均0.25点升高独立相关（P = .04）。校正初始卒中严重程度（美国国立卫生研究院卒中量表评分）和其他基线特征后，与缺血性卒中相比，ICH对死亡率无影响（几率1.01，95％置信区间.68-1.49）。结论：在有意识的中风患者中，ICH是神经系统预后不良的独立预测因素，几乎是长期残疾的几率。但是，在针对初始卒中严重程度和其他基线特征进行调整后，与缺血性卒中相比，ICH与更高的死亡率无关。

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