Stroke: 缺血性卒中后恶性脑水肿的早期预测模型

2018-12-16 MedSci MedSci原创

缺血性中风后如果发生恶性脑水肿那么患者的死亡率会很高。因此,早期预测恶性脑水肿的发生很重要,因此,本项研究中研究人员系统审查了目前现有的预测模型,以确定预测恶性水肿发生的可靠标志物。

背景和目的
缺血性中风后如果发生恶性脑水肿那么患者的死亡率会很高。因此,早期预测恶性脑水肿的发生很重要,因此,本项研究中研究人员系统审查了目前现有的预测模型,以确定预测恶性水肿发生的可靠标志物。

方法
研究人员搜索数据库纳入了评估缺血性卒中后恶性脑水肿的预测因子或预测模型的研究。通过17项工具评估研究质量。在随机效应模型中汇总优势比,均值差或标准化均值差。描述性地分析了所有预测模型的优劣。

结果
本项研究共纳入了38项研究(3278名患者),其中24个临床因素,7个为影像学指标,13项血清生物标志物和4项模型。研究发现,恶性水肿与年龄较小有关(n = 2075;平均差异,-4.42; 95%CI,-6.63~-2.22),初始计算机断层扫描中大脑中动脉区域的实际低衰减>50%与恶性脑水肿的发生也有明显关系(n = 420;优势比,5.33; 95%CI,2.93-9.68)。血运重建(n = 1600,优势比,0.37; 95%CI,0.24-0.57)与恶性水肿的风险较低相关。四个预测模型均显示总体C-Index> 0.70,存在过度拟合的风险。

结论
年龄越小,计算机断层扫描的实质低衰减越大,是恶性水肿的可靠早期预测因子。血运重建可降低恶性水肿的风险。

原始出处:

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    2018-12-18 小华子
  7. [GetPortalCommentsPageByObjectIdResponse(id=1893130, encodeId=b021189313010, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sun Jun 02 22:34:00 CST 2019, time=2019-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1671361, encodeId=225516e136119, content=<a href='/topic/show?id=9f4e360191a' target=_blank style='color:#2F92EE;'>#卒中后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36019, encryptionId=9f4e360191a, topicName=卒中后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff7426824786, createdName=waiwai3039, createdTime=Thu Jul 11 17:34:00 CST 2019, time=2019-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806293, encodeId=bfd5180629309, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Fri Jun 07 08:34:00 CST 2019, time=2019-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259603, encodeId=eb4a12596037a, 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=54, 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=Tue Dec 18 02:34:00 CST 2018, time=2018-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262760, encodeId=12c51262e6069, content=<a href='/topic/show?id=52941002359d' target=_blank style='color:#2F92EE;'>#预测模型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100235, encryptionId=52941002359d, topicName=预测模型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3ff68, createdName=维他命, createdTime=Tue Dec 18 02:34:00 CST 2018, time=2018-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333422, encodeId=fb411333422a5, content=<a href='/topic/show?id=4ce26423802' target=_blank style='color:#2F92EE;'>#水肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, 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=Tue Dec 18 02:34:00 CST 2018, time=2018-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026240, encodeId=0d87102624074, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Sun Dec 16 14:34:00 CST 2018, time=2018-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047651, encodeId=59ae104e6518a, content=梅斯里提供了很多疾病的模型计算公式,赞一个!, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sun Dec 16 14:34:00 CST 2018, time=2018-12-16, status=1, ipAttribution=)]
    2018-12-16 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1893130, encodeId=b021189313010, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sun Jun 02 22:34:00 CST 2019, time=2019-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1671361, encodeId=225516e136119, content=<a href='/topic/show?id=9f4e360191a' target=_blank style='color:#2F92EE;'>#卒中后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36019, encryptionId=9f4e360191a, topicName=卒中后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff7426824786, createdName=waiwai3039, createdTime=Thu Jul 11 17:34:00 CST 2019, time=2019-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806293, encodeId=bfd5180629309, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Fri Jun 07 08:34:00 CST 2019, time=2019-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259603, encodeId=eb4a12596037a, 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=54, 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=Tue Dec 18 02:34:00 CST 2018, time=2018-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262760, encodeId=12c51262e6069, content=<a href='/topic/show?id=52941002359d' target=_blank style='color:#2F92EE;'>#预测模型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100235, encryptionId=52941002359d, topicName=预测模型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3ff68, createdName=维他命, createdTime=Tue Dec 18 02:34:00 CST 2018, time=2018-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333422, encodeId=fb411333422a5, content=<a href='/topic/show?id=4ce26423802' target=_blank style='color:#2F92EE;'>#水肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, 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=Tue Dec 18 02:34:00 CST 2018, time=2018-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026240, encodeId=0d87102624074, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Sun Dec 16 14:34:00 CST 2018, time=2018-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047651, encodeId=59ae104e6518a, content=梅斯里提供了很多疾病的模型计算公式,赞一个!, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sun Dec 16 14:34:00 CST 2018, time=2018-12-16, status=1, ipAttribution=)]
    2018-12-16 CHANGE

    梅斯里提供了很多疾病的模型计算公式,赞一个!

    0