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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Predictors of in-hospital mortality and the risk of symptomatic intracerebral hemorrhage after thrombolytic therapy with recombinant tissue plasminogen activator in acute ischemic stroke
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Predictors of in-hospital mortality and the risk of symptomatic intracerebral hemorrhage after thrombolytic therapy with recombinant tissue plasminogen activator in acute ischemic stroke

机译：重组组织纤溶酶原激活剂溶栓治疗急性缺血性卒中后院内死亡率和症状性脑出血风险的预测因素

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摘要

Recombinant tissue-plasminogen activator (rt-PA) therapy improves functional outcome in patients with acute ischemic stroke (AIS) but is associated with serious complications, including symptomatic intracerebral hemorrhage (sICH). This study aimed to determine the independent predictors of in-hospital mortality (IHM) and the risk of sICH after rt-PA therapy. A total of 1007 patients (mean age, 72 ± 12 years; 52% women; mean National Institutes of Health Stroke Scale [NIHSS] score, 11.6 ± 5.6) with AIS treated with rt-PA were enrolled in this study during a 42-month period beginning in November 2007. Univariate and multivariate regression analyses were performed to estimate the predictors of IHM. Eighty-three of the 1007 patients (8.2%) died during hospitalization (mean duration of hospitalization, 10 ± 1.8 days). Logistic regression estimated the following independent predictors for IHM: age ≥80 years (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.1-3.0; P =.031), aphasia (OR, 2.0; 95% CI, 1.1-3.4; P =.017), altered consciousness (OR, 3.6; 95% CI, 2.0-6.2; P <.001), hypertension (OR, 4; 95% CI, 1.4-11.6; P = 0.012), sICH (OR, 5.9; 95% CI, 2.9-11.9; P < 0.001), and pneumonia during hospitalization (OR, 3.0; 95% CI, 1.8-5.0; P <.001). After rt-PA therapy, 58 patients (5.8%) sustained sICH, 16 (28%) of whom died. Increased age (P =.008), higher NIHSS score (P =.011), and atrial fibrillation (P =.025) were correlated with sICH. The findings from this study may help clinicians estimate the prognosis and risk of sICH in patients with AIS treated with rt-PA.
机译：重组组织纤溶酶原激活剂（rt-PA）疗法可改善急性缺血性卒中（AIS）患者的功能结局，但会伴有严重的并发症，包括有症状的脑出血（sICH）。这项研究旨在确定rt-PA治疗后院内死亡率（IHM）和sICH风险的独立预测因子。这项研究共纳入了1007名接受rt-PA治疗的AIS患者（平均年龄，72±12岁; 52％，女性;美国国立卫生研究院卒中量表[NIHSS]平均得分，11.6±5.6）。从2007年11月开始的一个月期间。进行了单因素和多元回归分析以估计IHM的预测因子。 1007例患者中有83例（8.2％）在住院期间死亡（平均住院时间10±1.8天）。 Logistic回归估计了以下IHM的独立预测因子：年龄≥80岁（优势比[OR]，1.8; 95％置信区间[CI]，1.1-3.0; P = .031），失语症（OR，2.0; 95％CI ，1.1-3.4; P = .017），意识改变（OR，3.6; 95％CI，2.0-6.2; P <.001），高血压（OR，4; 95％CI，1.4-11.6; P = 0.012） ，sICH（OR，5.9; 95％CI，2.9-11.9; P <0.001）和住院期间的肺炎（OR，3.0; 95％CI，1.8-5.0; P <.001）。 rt-PA治疗后，58例患者（5.8％）患有sICH，其中16例（28％）死亡。年龄增加（P = .008），NIHSS评分较高（P = .011）和房颤（P = .025）与sICH相关。这项研究的发现可能有助于临床医生评估接受rt-PA治疗的AIS患者的sICH的预后和风险。

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