Correlation of Immune-Inflammatory Markers with Clinical Features and Novel Location-Specific Nomograms for Short-Term Outcomes in Patients with Intracerebral Hemorrhage

被引:3
作者
Hsu, Hsien-Ta [1 ,2 ]
Chen, Pei-Ya [2 ,3 ,4 ]
Tzeng, I-Shiang [5 ]
Hsu, Po-Jen [3 ,4 ]
Lin, Shinn-Kuang [2 ,3 ,4 ]
机构
[1] Buddhist Tzu Chi Med Fdn, Taipei Tzu Chi Hosp, Div Neurosurg, New Taipei 23142, Taiwan
[2] Tzu Chi Univ, Sch Med, Hualien 97004, Taiwan
[3] Buddhist Tzu Chi Med Fdn, Taipei Tzu Chi Hosp, Stroke Ctr, New Taipei 23142, Taiwan
[4] Buddhist Tzu Chi Med Fdn, Taipei Tzu Chi Hosp, Dept Neurol, New Taipei 23142, Taiwan
[5] Buddhist Tzu Chi Med Fdn, Taipei Tzu Chi Hosp, Dept Res, New Taipei 23142, Taiwan
关键词
Glasgow Coma Scale; immune-inflammatory marker; intracerebral hemorrhage; intracerebral hemorrhage score; nomogram; unfavorable outcome; mortality; TO-LYMPHOCYTE RATIO; GRADING SCALE; HOSPITAL MORTALITY; STROKE; NEUTROPHIL; SCORE; ASSOCIATION; PREDICTION; GUIDELINES; SYSTEM;
D O I
10.3390/diagnostics12030622
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
(1) Background: We investigated the association of four immune-inflammatory markers with clinical features and established location-specific nomograms to predict mortality risk in patients with intracerebral hemorrhage (ICH). (2) Methods: We retrospectively enrolled 613 inpatients with acute ICH. (3) Results: Overall mortality was 22%, which was highest in pontine hemorrhage and lowest in thalamic hemorrhage. All four immune-inflammatory markers exhibited a positive linear correlation with glucose, ICH volume, ICH score, and discharge Modified Rankin Scale (mRS) score. Significant predictors of death due to lobar/putaminal hemorrhage were age, glucose and creatinine levels, initial Glasgow Coma Scale (GCS) score, ICH volume, and presence of intraventricular hemorrhage. None of the immune-inflammatory markers were significant predictors of unfavorable outcome or death. We selected significant factors to establish nomograms for predicting death due to lobar/putaminal, thalamic, pontine, and cerebellar hemorrhages. The C-statistic for predicting death in model I (comprising factors in the establishment of the nomogram) in each type of ICH was higher than that in model II (comprising ICH score alone), except for cerebellar hemorrhage. These nomograms for predicting death had good discrimination (C-index: 0.889 to 0.975) and prediction probabilities (C-index: 0.890 to 0.965). (4) Conclusions: Higher immune-inflammatory markers were associated with larger ICH volume, worse initial GCS, and unfavorable outcomes, but were not independent prognostic predictors. The location-specific nomograms provided novel and accurate models for predicting mortality risk.
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页数:13
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