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Stroke:恶性前循环卒中(EDEMA)评分可以检测脑水肿!

2017-05-10 xing.T MedSci原创

EDEMA评分可识别高危的致死性恶性水肿患者。虽然它需要进行外部验证,这个量表可以帮助这类患者进行更快的分流决策。

快速识别脑卒中后恶性水肿的高危人群将有助于监测和潜在手术的分流。进行准确的分流决策仅依靠入院数据可能还不够。近日,卒中领域权威杂志Stroke上发表了一篇研究文章,研究人员采用24小时内的临床和影像学指标开发了一个风险预测评分来更好地预测潜在的致死性恶性水肿。

研究人员将入院时诊断代码为脑水肿和缺血性脑卒中、NIHSS评分(国家卫生研究院卒中评分)≥8并且在脑卒中发作24小时内进行了头部CT检查的患者纳入研究。该研究的主要结局为可能的致死性恶性水肿,其定义为中线移位≥5毫米或去骨瓣减压术的死亡。研究人员在发病24小时内进行了多变量分析数据。

222例患者中有33%的患者发生潜在致死性恶性水肿。最终模型的C统计值在推导队列为0.76(可信区间为0.68-0.82),在引导验证样本中为0.75(可信区间为0.72-0.77)。恶性前循环卒中水肿增强检测评分(EDEMA评分)是建立在以下独立预测因子的基础上:基底池消失(=3);葡萄糖≥150(=2);未进行tPA(组织型纤溶酶原激活剂)或取栓治疗(=1);中线移位>0-3(=1),3-6(=2)和6-9(=4);>9(=7);既往无卒中病史(=1)。以上得分大于7分与93%的阳性预测值相关。

EDEMA评分可识别高危的致死性恶性水肿患者。虽然它需要进行外部验证,这个量表可以帮助这类患者进行更快的分流决策。

原始出处:

Charlene Jennifer Ong,et al. Enhanced Detection of Edema in Malignant Anterior Circulation Stroke (EDEMA) Score A Risk Prediction Tool.Stroke. 2017. https://doi.org/10.1161/STROKEAHA.117.016733

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1259595, encodeId=bee112595958c, content=<a href='/topic/show?id=1d2f8490308' target=_blank style='color:#2F92EE;'>#脑水肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84903, encryptionId=1d2f8490308, topicName=脑水肿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Fri May 12 08:10:00 CST 2017, time=2017-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317287, encodeId=b829131e28729, content=<a href='/topic/show?id=74916e0414' target=_blank style='color:#2F92EE;'>#EMA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6704, encryptionId=74916e0414, topicName=EMA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Fri May 12 08:10:00 CST 2017, time=2017-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333357, encodeId=12b3133335e58, content=<a href='/topic/show?id=4ce26423802' target=_blank style='color:#2F92EE;'>#水肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64238, encryptionId=4ce26423802, topicName=水肿)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKCRibWHQArPHdSkqP90U1HwwqlGeU7BUgzY240D3v2ibBDJ09ybkGkwOjxz7qRmngZaGlK1taX6hfA/132, createdBy=2e772500094, createdName=小华子, createdTime=Fri May 12 08:10:00 CST 2017, time=2017-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196567, encodeId=364019656ee6, content=厉害厉害……学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCSvgHPvuQp0g9YLQuk8Dv2tO2J8cA1nBOPWOR46Rv1IMw309iaVI4zibSE52MibbXtA54h46besGYv6vpQfsUHpY9TaCKOVRmm2A/0, createdBy=14511949364, createdName=尹玉伟, createdTime=Thu May 11 09:34:37 CST 2017, time=2017-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196442, encodeId=6ef81964420f, content=学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Thu May 11 06:33:29 CST 2017, time=2017-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196354, encodeId=a5691963546f, content=学习啦,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Thu May 11 00:12:55 CST 2017, time=2017-05-11, status=1, ipAttribution=)]
    2017-05-12 fengyi812
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    2017-05-12 小华子
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    2017-05-11 尹玉伟

    厉害厉害……学习了

    0

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    2017-05-11 meiliwuxian

    学习一下

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1259595, encodeId=bee112595958c, content=<a href='/topic/show?id=1d2f8490308' target=_blank style='color:#2F92EE;'>#脑水肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84903, encryptionId=1d2f8490308, topicName=脑水肿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Fri May 12 08:10:00 CST 2017, time=2017-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317287, encodeId=b829131e28729, content=<a href='/topic/show?id=74916e0414' target=_blank style='color:#2F92EE;'>#EMA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6704, encryptionId=74916e0414, topicName=EMA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Fri May 12 08:10:00 CST 2017, time=2017-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333357, encodeId=12b3133335e58, content=<a href='/topic/show?id=4ce26423802' target=_blank style='color:#2F92EE;'>#水肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64238, encryptionId=4ce26423802, topicName=水肿)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKCRibWHQArPHdSkqP90U1HwwqlGeU7BUgzY240D3v2ibBDJ09ybkGkwOjxz7qRmngZaGlK1taX6hfA/132, createdBy=2e772500094, createdName=小华子, createdTime=Fri May 12 08:10:00 CST 2017, time=2017-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196567, encodeId=364019656ee6, content=厉害厉害……学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCSvgHPvuQp0g9YLQuk8Dv2tO2J8cA1nBOPWOR46Rv1IMw309iaVI4zibSE52MibbXtA54h46besGYv6vpQfsUHpY9TaCKOVRmm2A/0, createdBy=14511949364, createdName=尹玉伟, createdTime=Thu May 11 09:34:37 CST 2017, time=2017-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196442, encodeId=6ef81964420f, content=学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Thu May 11 06:33:29 CST 2017, time=2017-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196354, encodeId=a5691963546f, content=学习啦,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Thu May 11 00:12:55 CST 2017, time=2017-05-11, status=1, ipAttribution=)]
    2017-05-11 tanxingdoctor

    学习啦,谢谢分享

    0

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