Stroke:动脉瘤性蛛网膜下腔出血后长期的超额死亡率

2015-06-05 李志行 译 MedSci原创

动脉瘤性蛛网膜下腔出血(aSAH)具有高病死率的特点,进而导致生产生命年的减少,然而针对患aSAH长期生存患者的相关数据还是比较匮乏。我们的研究目的为评估aSAH事件后的长期超额死亡率和相关风险因素。研究方法:通过1980年至2007年期间在赫尔辛基神经外科进行的回顾性随访研究对生存时间大于等于一年的aSAH生存者(n=3078)进行评估。随访开始于aSAH后一年直到其死亡或到2012年的研究终点

动脉瘤性蛛网膜下腔出血(aSAH)具有高病死率的特点,进而导致生产生命年的减少,然而针对患aSAH长期生存患者的相关数据还是比较匮乏。我们的研究目的为评估aSAH事件后的长期超额死亡率和相关风险因素。

研究方法:
通过1980年至2007年期间在赫尔辛基神经外科进行的回顾性随访研究对生存时间大于等于一年的aSAH生存者(n=3078)进行评估。随访开始于aSAH后一年直到其死亡或到2012年的研究终点。通过匹配一般人群得到死亡率和相对生存率。

研究结果:
相比较一般人群,20年后aSAH生存者表现出17%的超额死亡率。即使是年轻的患者以及恢复较好的患者也表现出超额死亡率。在多发性动脉瘤、老年、较差的术前临床状况、保守的动脉瘤治疗以及一年时临床结局不良的患者中超额死亡率最高。

研究结论:
即使在一开始能够得到较理想的预后,但经过匹配一般人群,生存者依然会经历长期超额死亡率。年轻人群中的心血管疾病以及脑血管事件做为死因的比例偏大,这提示针对血管风险因素治疗的重要性。从aSAH中的恢复的年轻患者和患有多发性动脉瘤的患者应该予以随访以及更加积极的治疗。

原始出处:
Justiina Huhtakangas, Hanna Lehto, Karri Seppä, Riku Kivisaari, Mika Niemelä, Juha Hernesniemi, and Martin Lehecka
Long-Term Excess Mortality After Aneurysmal Subarachnoid Hemorrhage
Stroke 2015; first published on June 4 2015 as doi:10.1161/STROKEAHA.115.009288

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    2015-06-09 huaxipanxing

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