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Prognostic models for survival and consciousness in patients with primary brainstem hemorrhage

OBJECTIVES: Primary brainstem hemorrhage (PBSH) is one of the most catastrophic spontaneous intracerebral hemorrhage diseases, with a mortality rate of 70–80%. We explored the predictive factors for survival and consciousness in patients with PBSH (ClinicalTrials.gov ID: NCT04910490). METHODS: We re...

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Autores principales: Zhou, Jingyi, Wang, Rui, Mao, Jizhong, Gu, Yichen, Shao, Anwen, Liu, Fengqiang, Zhang, Jianmin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9995821/
https://www.ncbi.nlm.nih.gov/pubmed/36908614
http://dx.doi.org/10.3389/fneur.2023.1126585
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author Zhou, Jingyi
Wang, Rui
Mao, Jizhong
Gu, Yichen
Shao, Anwen
Liu, Fengqiang
Zhang, Jianmin
author_facet Zhou, Jingyi
Wang, Rui
Mao, Jizhong
Gu, Yichen
Shao, Anwen
Liu, Fengqiang
Zhang, Jianmin
author_sort Zhou, Jingyi
collection PubMed
description OBJECTIVES: Primary brainstem hemorrhage (PBSH) is one of the most catastrophic spontaneous intracerebral hemorrhage diseases, with a mortality rate of 70–80%. We explored the predictive factors for survival and consciousness in patients with PBSH (ClinicalTrials.gov ID: NCT04910490). METHODS: We retrospectively reviewed 211 patients with PBSH admitted to our institution between January 2014 and October 2020. Clinical outcomes included the 30-day survival rate and the 90-day consciousness rate as evaluated by the National Institutes of Health Stroke Scale score. Multiple logistic regression analysis was performed. RESULTS: The overall 30-day survival rate of 211 patients with PBSH was 70%. Several predictive factors including hematoma volume, hematoma location, activated partial thromboplastin time (APTT) upon admission, and therapeutic strategy were significantly related to 30-day survival. Compared with conservative treatment, stereotactic aspiration in our prediction model is strongly associated with improved 30-day survival (odds ratio, 6.67; 95% confidence interval, 3.13–14.29; P < 0.001). The prognosis prediction model of 90-day consciousness including factors such as mydriasis, APTT value, hematoma location, and hematoma volume upon admission has a good predictive effect (AUC, 0.835; 95% confidence interval, 0.78–0.89; P < 0.001). CONCLUSION: In patients with PBSH, conscious state upon admission, coagulation function, hematoma volume, hematoma location, and therapeutic strategy were significantly associated with prognosis. Stereotactic aspiration could significantly reduce the 30-day mortality rate.
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spelling pubmed-99958212023-03-10 Prognostic models for survival and consciousness in patients with primary brainstem hemorrhage Zhou, Jingyi Wang, Rui Mao, Jizhong Gu, Yichen Shao, Anwen Liu, Fengqiang Zhang, Jianmin Front Neurol Neurology OBJECTIVES: Primary brainstem hemorrhage (PBSH) is one of the most catastrophic spontaneous intracerebral hemorrhage diseases, with a mortality rate of 70–80%. We explored the predictive factors for survival and consciousness in patients with PBSH (ClinicalTrials.gov ID: NCT04910490). METHODS: We retrospectively reviewed 211 patients with PBSH admitted to our institution between January 2014 and October 2020. Clinical outcomes included the 30-day survival rate and the 90-day consciousness rate as evaluated by the National Institutes of Health Stroke Scale score. Multiple logistic regression analysis was performed. RESULTS: The overall 30-day survival rate of 211 patients with PBSH was 70%. Several predictive factors including hematoma volume, hematoma location, activated partial thromboplastin time (APTT) upon admission, and therapeutic strategy were significantly related to 30-day survival. Compared with conservative treatment, stereotactic aspiration in our prediction model is strongly associated with improved 30-day survival (odds ratio, 6.67; 95% confidence interval, 3.13–14.29; P < 0.001). The prognosis prediction model of 90-day consciousness including factors such as mydriasis, APTT value, hematoma location, and hematoma volume upon admission has a good predictive effect (AUC, 0.835; 95% confidence interval, 0.78–0.89; P < 0.001). CONCLUSION: In patients with PBSH, conscious state upon admission, coagulation function, hematoma volume, hematoma location, and therapeutic strategy were significantly associated with prognosis. Stereotactic aspiration could significantly reduce the 30-day mortality rate. Frontiers Media S.A. 2023-02-23 /pmc/articles/PMC9995821/ /pubmed/36908614 http://dx.doi.org/10.3389/fneur.2023.1126585 Text en Copyright © 2023 Zhou, Wang, Mao, Gu, Shao, Liu and Zhang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Zhou, Jingyi
Wang, Rui
Mao, Jizhong
Gu, Yichen
Shao, Anwen
Liu, Fengqiang
Zhang, Jianmin
Prognostic models for survival and consciousness in patients with primary brainstem hemorrhage
title Prognostic models for survival and consciousness in patients with primary brainstem hemorrhage
title_full Prognostic models for survival and consciousness in patients with primary brainstem hemorrhage
title_fullStr Prognostic models for survival and consciousness in patients with primary brainstem hemorrhage
title_full_unstemmed Prognostic models for survival and consciousness in patients with primary brainstem hemorrhage
title_short Prognostic models for survival and consciousness in patients with primary brainstem hemorrhage
title_sort prognostic models for survival and consciousness in patients with primary brainstem hemorrhage
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9995821/
https://www.ncbi.nlm.nih.gov/pubmed/36908614
http://dx.doi.org/10.3389/fneur.2023.1126585
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