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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Renal dysfunction and discharge destination in patients with intracerebral hemorrhage
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Renal dysfunction and discharge destination in patients with intracerebral hemorrhage

机译：脑出血患者的肾功能不全和出院目的地

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摘要

Identifying predictors of outcome after intracerebral hemorrhage (ICH) may improve understanding of factors that contribute to recovery. We determined whether indices of renal insufficiency would predict early outcome in patients with ICH without established chronic kidney disease (CKD). Consecutive ICH patients discharged from a university stroke service between September 2005 and June 2009 were evaluated for proteinuria and estimated glomerular filtration rate (eGFR) 60 mL/min per 1.73 m 2 on admission. Patients with known CKD were excluded. The outcome assessed was discharge to home directly from the inpatient stroke service (vs transfer to rehabilitation, higher-level care unit, or nursing home). Independent effects of renal insufficiency on outcome were evaluated using multivariate regression modeling. Of 94 patients with recent ICH, 84 (89%) met the study inclusion criteria. In unadjusted analyses, patients discharged to home were less likely to have proteinuria (28% vs 57.9%; P = .02) and low eGFR (12.1% vs 30.2%; P = .06). After adjusting for 13 confounders, the likelihood of being discharged to home were lower in patients with initial proteinuria alone (odds ratio [OR] = 0.41; 95% confidence interval [CI] = 0.07-2.58), low eGFR alone (OR = 0.24; 95% CI = 0.04-1.39), or both conditions simultaneously (OR = 0.20; 95% CI = 0.02-1.76), but none of these associations reached statistical significance. In this study, proteinuria or low eGFR on admission were not independently linked with discharge directly to home. Larger studies are needed to further explore this issue, however.
机译：确定脑出血（ICH）后结果的预测指标可能会增进对有助于恢复的因素的了解。我们确定了肾功能不全的指标是否可以预测没有确定的慢性肾脏病（CKD）的ICH患者的早期结果。对2005年9月至2009年6月从大学卒中服务中出院的连续ICH患者进行蛋白尿评估，评估其入院时每1.73 m 2肾小球滤过率（eGFR）<60 mL / min。已知CKD的患者被排除在外。评估的结果是直接从住院卒中服务出院（与转入康复，更高级别的护理单位或疗养院相比）。使用多元回归模型评估了肾功能不全对预后的独立影响。在94名近期患有ICH的患者中，有84名（89％）符合研究纳入标准。在未经校正的分析中，出院回家的患者较少有蛋白尿（28％比57.9％; P = .02）和低eGFR（12.1％比30.2％; P = .06）。调整了13个混杂因素后，仅具有初始蛋白尿（赔率[OR] = 0.41; 95％置信区间[CI] = 0.07-2.58），单独的eGFR低（OR = 0.24）的患者出院的可能性较低; 95％CI = 0.04-1.39），或同时满足两个条件（OR = 0.20; 95％CI = 0.02-1.76），但这些关联均未达到统计学意义。在这项研究中，入院时蛋白尿或低eGFR并不直接与出院直接相关。但是，需要更大的研究来进一步探讨这个问题。

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