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目的探讨脑出血患者早期死亡及致残的危险因素。方法回顾性收集2004年9月～2006年6月南京医科大学附属南京第一医院神经内科住院的312例急性脑出血病例,采用电话或写信等方式随访患者发病后3月的生存及残疾情况。采用Logistic回归分析对影响患者死亡及致残的27项危险因素进行单因素和多因素分析。结果脑出血患者周一周二就诊病死率及致残率较其他时间低。影响脑出血患者死亡的危险因素有年龄(P=0.012)、意识障碍(P=0.016)、入院时收缩压(P=0.018)、尿素氮(P=0.036)、低蛋白血症(P=0.000)、合并感染(P=0.000)、合并消化道出血(P=0.031);影响脑出血患者致残的危险因素有性别(P=0.023)、年龄(P=0.000)、意识障碍(P=0.000)、合并感染(P=0.031)。结论高龄、有意识障碍、入院时收缩压高、尿素氮高、有低蛋白血症、合并感染、合并消化道出血是脑出血患者死亡的独立危险因素。性别、年龄、有意识障碍、合并感染是脑出血患者致残的独立危险因素。
Objective To explore the early death and disability risk factors of patients with cerebral hemorrhage. Methods We retrospectively collected 312 cases of acute cerebral hemorrhage hospitalized in Department of Neurology, Nanjing First Hospital Affiliated to Nanjing Medical University from September 2004 to June 2006. Survival and disability in March after the onset of the disease were investigated by telephone or writing letters . Logistic regression analysis was used to univariate and multivariate analysis of 27 risk factors affecting death and disability in patients. Results The patients with cerebral hemorrhage showed lower mortality and morbidity than those at other times on Monday and Tuesday. The risk factors of death in patients with intracerebral hemorrhage were age (P = 0.012), disturbance of consciousness (P = 0.016), systolic blood pressure on admission (P = 0.018), urea nitrogen (P = 0.036), hypoproteinemia (P = 0.000), combined with gastrointestinal bleeding (P = 0.031). The risk factors of disability in patients with cerebral hemorrhage were gender (P = 0.023), age (P = 0.000), disturbance of consciousness ), Combined infection (P = 0.031). Conclusions The elderly, patients with unconsciousness, high systolic blood pressure on admission, high blood urea nitrogen, hypoproteinemia, combined infection and gastrointestinal bleeding are the independent risk factors of death in patients with intracerebral hemorrhage. Gender, age, disturbance of consciousness and co-infection were independent risk factors of disability in patients with cerebral hemorrhage.