"Prehospital Ultra-Early Neurological Deterioration in Intracerebral Hemorrhage: Definition, Prevalence, and Association with Outcomes"

作者全名："Deng, Lan; Li, Zuo-Qiao; Yang, Wen-Song; Li, Rui; Lv, Xin-Ni; Li, Yu-Lun; Wang, Zi-Jie; Hu, Xiao; Zhao, Li-Bo; Lv, Fa-Jin; Yao, Sheng-Tao; Cao, Fang; Xie, Peng; Li, Qi"

作者地址："[Deng, Lan; Li, Zuo-Qiao; Yang, Wen-Song; Li, Rui; Lv, Xin-Ni; Wang, Zi-Jie; Hu, Xiao; Xie, Peng; Li, Qi] Chongqing Med Univ, Affiliated Hosp 1, Dept Neurol, Chongqing, Peoples R China; [Li, Yu-Lun; Lv, Fa-Jin] Chongqing Med Univ, Affiliated Hosp 1, Dept Radiol, Chongqing, Peoples R China; [Zhao, Li-Bo] Chongqing Med Univ, Yongchuan Hosp, Dept Neurol, Chongqing, Peoples R China; [Yao, Sheng-Tao; Cao, Fang] Zunyi Med Univ, Affiliated Hosp, Dept Neurosurg, Zunyi, Peoples R China"

通信作者："Li, Q (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Neurol, Chongqing, Peoples R China."

来源：CEREBROVASCULAR DISEASES

ESI学科分类：NEUROSCIENCE & BEHAVIOR

WOS号：WOS:000898409600001

JCR分区：Q3

影响因子：2.2

年份：2023

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Ultra-early neurological deterioration; Intracerebral hemorrhage; Prehospital; Outcome

摘要："Introduction: The objective of this study was to define prehospital ultra-early neurological deterioration (UND) and to investigate the association with functional outcomes in patients with intracerebral hemorrhage (ICH). Methods: We conducted a prospective cohort study of consecutive acute ICH patients. The stroke severity at onset and hospital admission was assessed using the Chongqing Stroke Scale (CQSS), and prehospital UND was defined as a CQSS increase of >= 2 points between symptoms onset and admission. Early neurological deterioration (END) was defined as the increase of >= 4 points in NIHSS score within the first 24 h after admission. Poor outcome was defined as a modified Rankin Scale (mRS) of 4-6 at 3 months. Results: Prehospital UND occurred in 29 of 169 patients (17.2%). Patients with prehospital UND had a median admission NIHSS score of 17.0 as opposed to those without prehospital UND with a median NIHSS score of 8.5. There were three patterns of neurological deterioration: prehospital UND only in 21 of 169 patients (12.4%), END but without prehospital UND in 20 of 169 patients (11.8%), and continuous neurological deterioration in both phases in 8 patients (4.7%). Prehospital UND was associated with worse 3-month outcomes (median mRS score, 4.0 vs. 2.0, p = 0.002). After adjusting for age, time from onset to admission, END, and systolic blood pressure, prehospital UND was an independent predictor of poor outcome (odds ratio [OR] 3.27, 95% confidence interval [CI] 1.26-8.48, p = 0.015). Conclusion: Prehospital UND occurs in approximately 1 in 7 patients between symptom onset and admission and is associated with poor functional outcome in patients with ICH. Further research is needed to investigate the prehospital UND in the prehospital phase in the triage of patients with ICH."

基金机构："National Natural Science Foundation of China [82071337, 81960230]; National Key R&D Program of China [2018YFC1312200, 2018YFC1312203]; Chongqing High-End Young Investigator Project [2019GDRC005]; Science and Technology Innovation Project of ""Chengdu-Chongqing Economic Circle"" [KJCXZD2020019]; Chongqing Innovation Support Program for Returned Overseas Chinese Scholars [cx2020002]; Chongqing Science Fund for Distinguished Young Scholars [cstc2021jcyj-jqX0029]; First Affiliated Hospital of Chongqing Medical University PhD Innovation Program [CYYY-BSYJSCXXM-202206]"

基金资助正文："This study was supported by the National Natural Science Foundation of China (Grant No. 82071337, 81960230), the National Key R&D Program of China (Grant No. 2018YFC1312200 and 2018YFC1312203), the Chongqing High-End Young Investigator Project (Grant No. 2019GDRC005), the Science and Technology Innovation Project of ""Chengdu-Chongqing Economic Circle"" (Grant No. KJCXZD2020019), the Chongqing Innovation Support Program for Returned Overseas Chinese Scholars (Grant No. cx2020002), the Chongqing Science Fund for Distinguished Young Scholars (Grant No. cstc2021jcyj-jqX0029), and the First Affiliated Hospital of Chongqing Medical University PhD Innovation Program (Grant No. CYYY-BSYJSCXXM-202206)."