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Stroke:蛛网膜下腔出血后,慢性肝损伤可增加患者死亡率

2021-08-21 Freeman MedSci原创

在aSAH患者中,与非CLD相比,CLD与死亡率增加有关

 

慢性肝病(CLD)在临床上是指肝脏的一个疾病过程,包括肝实质的逐渐破坏和再生过程,导致纤维化和肝硬化。它包括广泛的肝脏病变,其中包括炎症(慢性肝炎)、肝硬化和肝细胞癌。

慢性肝病(CLD)是急性病患者发病率和死亡率增加的重要风险因素。对于神经外科医生来说,CLD及其对出血风险的影响是一个重要的临床问题。

目前,很少有研究调查动脉瘤性蛛网膜下腔出血(aSAH)患者的CLD和临床结果之间的关系。

藉此,四川大学华西医院的Yu Zhang等人, 评估了CLD与死亡率之间的关系,并调查了终末期肝病模型(MELD)评分是否是CLD和aSAH患者死亡率的独立预测因素。

他们在这项回顾性队列研究中,分析了2009年至2019年间华西医院收治的连续aSAH患者。主要结果是院内全因死亡率。

这项研究包括6228例aSAH,其中489例(7.9%)同时患有CLD。

在倾向匹配分析中,与非CLD相比,CLD与aSAH患者的死亡率增加有关(几率比,2.04[95% CI,1.43-2.92])。在患有CLD的aSAH患者中,终末期肝病模型高分仍与死亡率的增加有关。

这个研究的重要意义在于发现了:在aSAH患者中,与非CLD相比,CLD与死亡率增加有关。在患有CLD的aSAH患者中,较高的终末期肝病模型评分与死亡率的增加有关。


原文出处:
Zhang Y, Li L, Jia L, et al. Association of Chronic Liver Disease and Mortality in Patients With Aneurysmal Subarachnoid Hemorrhage. Stroke. Published online July 20, 2021. doi:10.1161/STROKEAHA.121.034136

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