高龄患者原发性脑内出血的趋势和预后因素

Kevin Gilotra, Melissa Janssen, Xiaoyue Zhang, Racheed Mani, Sujith Swarna, Cassie Wang, Reza Dashti
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引用次数: 0

摘要

导言:众所周知,原发性脑出血(ICH)的治疗效果不佳。高龄患者(80 岁以上)在原发性 ICH 后的发病率和死亡率明显更高。本研究旨在探讨八旬老人的发病状况和原有合并症,并将其住院治疗结果与年轻患者进行比较。方法 石溪 ICH 数据库是一个回顾性队列,包含 2011 年 1 月至 2021 年 1 月期间 814 名原发性 ICH 患者。数据库记录了患者的人口统计学数据、主要症状、既往病史和影像学检查结果。评估了住院结果和出院时的功能状态(以改良兰金量表(MRS)表示)。结果 我们的研究结果表明,八旬老人的基线 MRS 和合并症(如高血压、高脂血症和心房颤动)明显较高。同样,该年龄组使用他汀类药物、抗血小板药物和抗凝药物的比例也明显较高。八旬老人发病时的平均血肿量也较高。我们的研究结果表明,高龄组患者的出院 MRS 和住院死亡率明显更高。结论 目前的研究表明,八旬老人患原发性 ICH 的预后较差与多种原有因素有关。鉴于人口老龄化在世界许多地区都是一个重要的医疗保健问题,在未来的研究中继续探索这些关联至关重要。本研究的结果可用于规划有关该主题的进一步前瞻性研究。
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Trends and Predictors of Outcomes of Primary Intracerebral Hemorrhage in Very Elderly Patients.
Introduction Primary intracerebral hemorrhage (ICH) is known to have poor management outcome. Very elderly patients (age > 80) might have significantly higher incidence of worse management morbidity and mortality after primary ICH. The aim of this study was to explore presenting status and pre-existing comorbidities in octogenarians and compare the inpatient management outcomes with younger counterparts. Methods The Stony Brook ICH database is a retrospective cohort of 814 patients that presented with primary ICH from January 2011 to January 2021. Demographic data, presenting symptoms, pre-existing medical conditions, and imaging findings were recorded. Inpatient outcomes and functional state presented as modified Rankin Scale (MRS) at discharge were evaluated. Results Our results indicate octogenarians had significantly higher baseline MRS and comorbidities such as hypertension, hyperlipidemia, and atrial fibrillation at presentation. Similarly, usage of statins, antiplatelets, and anticoagulants were significantly higher in this age group. Octogenarians were also found to have higher average volume of hematoma at presentation. Our results indicate significantly higher discharge MRS, and inpatient mortality in the very elderly group. Conclusion Present study demonstrates a wide variety of pre-existing factors that correlate with worse outcomes amongst octogenarians presenting with primary ICH. Given the importance of aging population as a major healthcare issue in many parts of world, it is crucial to continue exploring these associations in future research. Findings of this study can be utilized to plan further prospective studies on this topic.
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