کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3094615 1581461 2016 10 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
The Effect of External Ventricular Drain Use in Intracerebral Hemorrhage
ترجمه فارسی عنوان
اثر استفاده از تخلیه بیضه خارجی در خونریزی داخل مغزی
موضوعات مرتبط
علوم زیستی و بیوفناوری علم عصب شناسی عصب شناسی
چکیده انگلیسی

BackgroundSpontaneous intracerebral hemorrhage (ICH) commonly presents with intraventricular hemorrhage (IVH) and remains a highly disabling form of stroke. External ventricular drains (EVDs) are associated with decreased short-term mortality, but indications for use and outcomes benefit are controversial.MethodsA multi-institutional, retrospective analysis of 563 patients with spontaneous ICH from 2010 to 2014 was performed with multivariate regression modeling. Primary outcomes were patient mortality and functional status with modified Rankin Scale score. To control for differences in patient and clinical characteristics influencing EVD utilization, a propensity score analysis was performed with patient-specific predicted probability of EVD use.ResultsThe multivariable logistic regression model showed odds of EVD use increased with younger age, lower ICH volume, ICH located outside the brainstem, increasing IVH volume, and concurrent IVH; the model showed high discriminability for EVD use (area under the receiver operating curve 0.84, R2McFadden = 0.27). The use of EVD was associated with lower 30-day mortality in patients with ICH score of 4 (odds ratio = 0.09, P = 0.002), greater ICH volume (>11 cc, odds ratio = 0.47, P = 0.019), and lower initial GCS (<13, 0.38, P = 0.003) in propensity score-adjusted analyses, as well as a trend toward lower mortality in patients with IVH and greater modified Graeb score. There was no benefit to morbidity in patients receiving an EVD.ConclusionsAmong a large, multi-institutional cohort, this statistical propensity analysis model accurately predicted EVD use in ICH. EVD use was associated with a trend towards decreased mortality but greater modified Rankin Scale score for functional outcomes.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: World Neurosurgery - Volume 94, October 2016, Pages 309–318
نویسندگان
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