Zhong Feng, Mengjia Lian, Lingxiao Li, Sa Wang
Department of Neurology, The First People’s Hospital of Wengling, Wengling 317500, Zhejiang, China
Objective: To explore and analyze the adverse effects of white matter lesions (WMLS) on long-term prognosis of intracerebral hemorrhage (ICH).
Methods: On the one hand, the patients with ICH who were hospitalized in The First People’s Hospital of Wengling from January 1, 2016 to April 30, 2017 were prospectively registered and their clinical data were recorded in detail. The risk factors that may affect the long-term prognosis of ICH were screened out by single factor analysis, and logistic regression analysis was used to determine the factors that affect the long-term prognosis of ICH. On the other hand, Goodman-Kruskal Gamma method was used to analyze the mutually restricted and changed relationship intensity and trend between the severity of WMLS and the degree of adverse long-term prognosis of stroke.
Results: There were significant differences in hypertension history, hematoma breaking into ventricle, hematoma irregularity, pulmonary infection, GCS (Glasgow Coma Scale) score, NIHSS (National Institutes of Health Stroke Scale) score, hematoma volume, and hemorrhage location at 6 months between baseline in the study group and that not included in the study group. Single factor analy- sis showed that age, smoking, hematoma volume, GCS score, NIHSS score, pulmonary infection, hematoma breaking into the ventricle, irregular hematoma, and systolic blood pressure at admission were risk factors influencing long-term prognosis. Logistic regression analysis showed that the independent risk factors for poor prognosis were NIHSS score (OR = 3.465, 95% CI: 1.205-9.953, P < 0.05), age (OR = 1.063, 95% CI: 1.000-1.131, P < 0.05), hematoma breaking into the ventricle (OR = 5.474, 95% CI: 1.426-20.992, P < 0.05), bleeding volume (OR = 2.364, 95% CI: 1.204-4.642, P < 0.05), and the severity of WMLS (OR = 5.704, 95% CI: 1.554-20.925, P < 0.05). Pulmonary infection had a tendency to influence the long-term prognosis of ICH (OR = 3.314, 95% CI: 0.923-11.884, P = 0.066). The severity of paraventricular WMLS and deep WMLS were positively correlated with the severity of long-term poor prognosis of ICH, and the correlation coefficients were 0.545 and 0.497, respectively.
Conclusion: The severity of WMLS is an independent risk factor for long-term poor prognosis in patients with ICH. The WMLS with deeper paraventricular WMLS can predict the long-term poor prognosis of ICH.
WMLS, ICH, long-term prognosis