摘要
目的 探讨自发性幕上脑出血 30 d死亡的危险因素 ,建立脑出血 30 d生存或死亡的概率预测模型 .方法 回顾性分析我院近 5 a来病房收治的 42 1例自发性幕上脑出血病例 ,对影响脑出血死亡的危险因素进行统计学分析 .结果 42 1例自发性幕上脑出血病人 ,30 d死亡率为 13.1% .单因素 χ2 检验表明 ,意识障碍、脑出血破入脑室、大出血量、伴发糖尿病、缺血性心脏病、消化道出血等 6个因素为自发性幕上脑出血 30 d死亡的危险因素 (P<0 .0 5 ) .多因素 L ogistic回归分析发现 ,仅有意识水平 (OR=5 .0 9,P<0 .0 1)和出血量 (OR=2 .5 5 ,P<0 .0 1)是脑出血 30 d死亡的独立的预测因子 .脑出血 30 d死亡的概率预测模型为 P =1/[1+e- ( - 4 .842 + 1 .6 6 3×意识水平 + 0 .91 5×出血量 ) ],该模型对脑出血 30 d死亡或生存预测总的正确率为 90 .5 % .结论 意识水平和出血量是影响自发性幕上脑出血 30
AIM To determine the most important predictors of 30 day mortality in patients with spontaneous supratentorial hemorrhage and to develop a predictive model of estimating 30 day mortality. METHODS Medical records and CT scans of 421 inpatients with spontaneous supratentorial hemorrhage were respectively reviewed. Independent predictors of 30 day mortality were determined by using univariate and multivariate statistical analysis. RESULTS Thirty days mortality for 421 cases of spontaneous supratentorial hemorrhage was 13.1%. Univariate analysis found that initial level of consciousness, ventricular spreading of hemorrhage, hemorrhage size, concomitant gastro intestinal bleeding, diabetes mellitus and ischemic heart disease were significantly correlated with 30 day mortality ( P <0.05). However multivariate logistic regression analysis showed that initial level of consciousness (OR=5.09, P <0.01) and hemorrhage size (OR=2.55, P <0.01) were the significant independent predictors. Using these two catagories variables, the resulting model, P =1/[1+e -(-4.842+1.663×consciousness+0.915×hem orrhage size) ], can predicted 30 day death or survival with an overall exactness of 90.5%. CONCLUSION Initial level of consciousness, in combination with hemorrhage size, was a powerful and ease to use predictor of 30 day mortality in patients with spontaneous supratentorial hemorrhage.
出处
《第四军医大学学报》
北大核心
2001年第10期942-944,共3页
Journal of the Fourth Military Medical University
