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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Neurochecks as a Biomarker of the Temporal Profile and Clinical Impact of Neurologic Changes after Intracerebral Hemorrhage
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Neurochecks as a Biomarker of the Temporal Profile and Clinical Impact of Neurologic Changes after Intracerebral Hemorrhage

机译：Neurochecks作为颞型剖面的生物标志物和脑出血后神经系统变化的临床影响

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Background: We sought to determine whether a quantitative neurocheck biomarker could characterize the temporal pattern of early neurologic changes after intracerebral hemorrhage (ICH), and the impact of those changes on long-term functional outcomes. Methods: We enrolled cases of spontaneous ICH in a prospective observational study. Patients underwent a baseline Glasgow Coma Scale (GCS) assessment, then hourly neurochecks using the GCS in a neuroscience intensive care unit. We identified a period of heightened neurologic instability by analyzing the average hourly rate of GCS change over 5 days from symptom onset. We used a multivariate regression model to test whether those early GCS score changes were independently associated with 3-month outcome measured by the modified Rankin Scale (mRS). Results: We studied 13,025 hours of monitoring from 132 cases. The average rate of neurologic change declined from 1.0 GCS points per hour initially to a stable baseline of .1 GCS points per hour beyond 12 hours from symptom onset (P < .05 for intervals before 12 hours). Change in GCS score within the initial 12 hours was an independent predictor of mRS at 3 months (odds ratio, .81 [95% confidence interval, .66-.99], P - .043) after adjustment for age, hematoma volume, hematoma location, initial GCS, and intraventricular hemorrhage. Conclusions: Neurochecks are effective at detecting clinically important neurologic changes in the intensive care unit setting that are relevant to patients' long-term outcomes. The initial 12 hours is a period of frequent and prognostically important neurologic changes in patients with ICH.
机译：背景：我们试图确定定量神经焦克生物标志物是否可以表征脑出血（ICH）后早期神经系统变化的时间模式，以及这些变化对长期功能结果的影响。方法：我们在预期观察研究中注册了自发性ICH的案例。患者接受了基线Glasgow Coma规模（GCS）评估，然后使用GCS在神经科学密集护理单元中的每小时Neurochecks。通过分析从症状发作到5天内，通过分析GCS变化的平均小时率，我们确定了一段高度的神经系统不稳定。我们使用了多元回归模型来测试这些早期GCS评分变化是否与由修改的Rankin规模（MRS）测量的3个月结果独立相关。结果：我们研究了132例案例的13,025小时。最初从每小时1.0GCS点下降到每小时1.0GCS点，从症状发作从症状发作超过12小时的稳定基线，从症状发作超过12小时。在初始12小时内的GCS评分的变化是3个月的MRS的独立预测因子（赔率比，.81 [95％置信区间，.66-.99]，p - .043）调整后，血肿体积，血肿位置，初始GCS和静脉内出血。结论：Neurochecks有效地检测与患者长期结果相关的重症监护单元设置中的临床重要的神经系统变化。最初的12小时是ICH患者频繁和预后重要的神经系统变化的时期。

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