脑出血患者卒中前痴呆与院内结局:基于中国卒中中心联盟登记数据库的分析  

Pre-Stroke Dementia and In-Hospital Outcomes in Patients with Intracerebral Hemorrhage:An Analysis Based on the China Stroke Center Alliance Registry Database

作　　者：李秋菊[1] 尹金风 王春娟 杨昕 任添华[1] 李子孝 谷鸿秋[2] 姜勇 LI Qiuju;YIN Jinfeng;WANG Chunjuan;YANG Xin;REN Tianhua;LI Zixiao;GU Hongqiu;JIANG Yong(International Medical Services,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;China National Clinical Research Center for Neurological Diseases,Beijing 100070,China;National Center for Healthcare Quality Management in Neurological Diseases,Beijing 100070,China;Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院国际医疗部,北京100070 [2]国家神经系统疾病临床医学研究中心 [3]国家神经系统疾病医疗质量控制中心 [4]首都医科大学附属北京天坛医院神经病学中心

出　　处：《中国卒中杂志》2025年第3期373-379,共7页Chinese Journal of Stroke

基　　金：科技创新2030项目(2021ZD0200801)。

摘　　要：目的调查脑出血患者卒中前痴呆的患病率及其与院内结局的关系。方法本研究数据来源于中国卒中中心联盟登记数据库2015年8月—2022年12月入组的脑出血患者。卒中前痴呆的判定依据患者病史中的自我报告。院内结局包括入院2 d内行走、卒中复发、院内死亡、院内并发症(肺栓塞、肺炎等)及出院回家。采用多因素logistic回归,分析脑出血患者卒中前痴呆与院内结局的相关性。结果本研究纳入109366例脑出血患者,男性68386例(62.5%),年龄63.0(53.0~72.0)岁,入院时NIHSS评分为6.0(2.0~13.0)分,住院天数为15.0(10.0~21.0)d。总计293例(0.3%)存在卒中前痴呆病史。与无卒中前痴呆患者相比,卒中前痴呆患者年龄更大、女性比例更高、受教育程度更低。多因素logistic回归分析发现,卒中前痴呆可能与更高的院内并发症(OR 2.35,95%CI 1.46~3.83),特别是肺炎(OR 2.52,95%CI 1.57~4.08)事件相关,但两组患者在卒中复发(OR 1.45,95%CI 0.63~2.88)、院内死亡(OR 1.43,95%CI 0.80~2.50)、出院回家(OR 0.83,95%CI 0.46~1.60)等结局上无显著差异。结论本研究中脑出血患者卒中前痴呆的患病率为0.3%,卒中前痴呆可能增加脑出血患者院内并发症尤其是肺炎的风险。Objective To investigate the prevalence of pre-stroke dementia in patients with intracerebral hemorrhage and its relationship with in-hospital outcomes.Methods The data for this study were derived from patients with intracerebral hemorrhage enrolled in the China Stroke Center Alliance registry database from August 2015 to December 2022.The determination of pre-stroke dementia was based on self-reports in the patient’s medical history.In-hospital outcomes included walking within 2 days of admission,stroke recurrence,in-hospital death,in-hospital complications(pulmonary embolism,pneumonia,etc.),and discharge to home.Multivariate logistic regression was used to analyze the correlation between pre-stroke dementia and in-hospital outcomes in patients with intracerebral hemorrhage.Results A total of 109366 patients with intracerebral hemorrhage were enrolled in this study,including 68386(62.5%)males,aged 63.0(53.0-72.0)years.The NIHSS score at admission was 6.0(2.0-13.0)points,and the length of hospitalization was 15.0(10.0-21.0)days.A total of 293(0.3%)patients had a history of pre-stroke dementia.Compared with patients without pre-stroke dementia,patients with pre-stroke dementia were older,had a higher proportion of females,and had lower levels of education.Multivariate logistic regression analysis showed that pre-stroke dementia may be associated with a higher risk of in-hospital complications(OR 2.35,95%CI 1.46-3.83),particularly pneumonia(OR 2.52,95%CI 1.57-4.08).However,there were no significant differences in outcomes such as stroke recurrence(OR 1.45,95%CI 0.63-2.88),in-hospital death(OR 1.43,95%CI 0.80-2.50),and discharge to home(OR 0.83,95%CI 0.46-1.60)between the two groups.Conclusions In this study,the prevalence of pre-stroke dementia in patients with intracerebral hemorrhage was 0.3%,and pre-stroke dementia may increase the risk of in-hospital complications,particularly pneumonia,in patients with intracerebral hemorrhage.

关 键 词：脑出血 卒中前痴呆 患病率 院内结局 

分 类 号：R74[医药卫生—神经病学与精神病学]