Acta neurochirurgica. Supplement · 2013
Clinical, transcranial Doppler ultrasound, radiological features and, prognostic significance of delayed cerebral ischemia.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Wong George Kwok Chu, Poon Wai Sang
Аннотация
OBJECTIVE: We aimed to investigate the profiles and prognostic values of delayed cerebral ischemia (DCI) and delayed cerebral infarction.
METHODS: IMASH (Intravenous Magnesium Sulphate for Aneurysmal Subarachnoid Hemorrhage) was registered at http://www.strokecenter.org/trials , and http://www.ClinicalTrials.gov (NCT00124150). Data of 327 patients were retrieved for logistic regression analyses.
RESULTS: Seventy-one (22%) patients developed DCI, and 35 (11%) patients developed delayed cerebral infarction. Only 18 (25%) patients with DCI and 7/35 (20%) patients with delayed cerebral infarction had mean middle cerebral artery velocities (transcranial Doppler ultrasound) over 120 cm/s. Regarding the prognostic significance of the components of DCI, delayed cerebral infarction predicted unfavorable outcome in terms of Extended Glasgow Outcome Scale (OR 3.1, 95% [CI] 1.3-7.8), poor outcome in terms of modified Rankin Scale (odds ratio [OR] 3.0, 95% confidence interval CI 1.2-7.7), and dependent activity of daily living in terms of Barthel Index (OR 3.6, 95% CI 1.4-9.2) at 6 months, after adjustments for other prognostic factors. On the other hand, clinical deterioration predicted inpatient mortality (OR 8.8, 95% CI 1.6-48.8) after adjustments for other prognostic factors.
CONCLUSIONS: Delayed cerebral ischemia and delayed cerebral infarction carried different prognostic values in aneurysmal subarachnoid hemorrhage.
METHODS: IMASH (Intravenous Magnesium Sulphate for Aneurysmal Subarachnoid Hemorrhage) was registered at http://www.strokecenter.org/trials , and http://www.ClinicalTrials.gov (NCT00124150). Data of 327 patients were retrieved for logistic regression analyses.
RESULTS: Seventy-one (22%) patients developed DCI, and 35 (11%) patients developed delayed cerebral infarction. Only 18 (25%) patients with DCI and 7/35 (20%) patients with delayed cerebral infarction had mean middle cerebral artery velocities (transcranial Doppler ultrasound) over 120 cm/s. Regarding the prognostic significance of the components of DCI, delayed cerebral infarction predicted unfavorable outcome in terms of Extended Glasgow Outcome Scale (OR 3.1, 95% [CI] 1.3-7.8), poor outcome in terms of modified Rankin Scale (odds ratio [OR] 3.0, 95% confidence interval CI 1.2-7.7), and dependent activity of daily living in terms of Barthel Index (OR 3.6, 95% CI 1.4-9.2) at 6 months, after adjustments for other prognostic factors. On the other hand, clinical deterioration predicted inpatient mortality (OR 8.8, 95% CI 1.6-48.8) after adjustments for other prognostic factors.
CONCLUSIONS: Delayed cerebral ischemia and delayed cerebral infarction carried different prognostic values in aneurysmal subarachnoid hemorrhage.
Предметные рубрики MeSH
Brain IschemiaCerebral InfarctionFemaleGlasgow Coma ScaleHumansMagnesium SulfateMaleMiddle Cerebral ArteryPredictive Value of TestsPrognosisRandomized Controlled Trials as TopicRegression AnalysisSubarachnoid HemorrhageTime FactorsTomography, X-Ray ComputedTreatment OutcomeUltrasonography, Doppler, Transcranial