Hematoma Density and Glasgow Coma Scale are Independent Predictors to Outcomes in Unilateral Chronic Subdural Hematoma

Jinn Rung Kuo; Che Chuan Wang; Huan-Fang Lee; Chung-Ching Chio; Kao Chang Lin

Hematoma Density and Glasgow Coma Scale are Independent Predictors to Outcomes in Unilateral Chronic Subdural Hematoma

貢獻的翻譯標題: 從腦出血密度及昏迷指數，作爲單側慢性硬腦膜下出血的預後指標及敏感度評估

Jinn Rung Kuo, Che Chuan Wang, Huan-Fang Lee, Chung-Ching Chio, Kao Chang Lin

護理學系

研究成果: Article › 同行評審

摘要

前言：使用昏迷指數(Glasgow Coma Scale)，預後指數(Glasgow Out-come Scale)，及電腦斷層(CT)的變項，來評估慢性硬腦膜下出血(CSDH)預後，文獻上並無一致性結論。
方法：從94年10月至98年3月，共收集了93例單一側CSDH的病人（年齡71±11歲）。每位病患皆於急診接受電腦斷層檢查並手術。排除了雙側硬腦膜下出血（由兩位放射專家確任），我們使用多個變項，如年齡、性別、昏迷指數、到院時間、出血位置、大小、厚度、密度(density)、腦移位情形、腦室大小(Evan's index)、第3腦室最大寬度(3Vmax. D)、皮質委縮等，來評估上述何者為最佳之預測因子。
結果：使用單變項及多變項分析，昏迷指數＜15預測不良預後爲一般的11倍之多(OR=11.2, CI=1.3-96.9, p=0.028)，出血密度高達7倍(OR=7.4, CI=1.8-31.7, p=0.007)，兩者皆呈統計性意義。利用Receiver-Operating Characteristic来測量兩者的顯著情形，敏感度高達73%，專一度爲85%。
結論：在本前驅性觀察研究發現，單一側硬腦膜下出血對於預後不良的最佳預測因子，爲出血密度及昏迷指數，預測敏感度高於7成。不同於以往文獻多為合併單、雙側病兆、或顱內出血討論，本文病患雖然不多，但仍具參考價值及意義。對於區域或社區型醫院之轉診，提供病患較準確評估及說明。

貢獻的翻譯標題	從腦出血密度及昏迷指數，作爲單側慢性硬腦膜下出血的預後指標及敏感度評估
原文	English
頁（從 - 到）	90-97
期刊	中華民國重症醫學雜誌＝ Taiwan Critical Care Medicine
卷	11
發行號	2
出版狀態	Published - 2010 8月 1

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@article{48c1044e7ce64e968aa737e3f283918f,

title = "Hematoma Density and Glasgow Coma Scale are Independent Predictors to Outcomes in Unilateral Chronic Subdural Hematoma",

abstract = "Introduction: The relationships between Glasgow Outcome Scale (GOS), Glasgow Coma Scale (GCS) and brain computerized tomography (CT) with unilateral chronic subdural hematoma (CSDH) are not consistent in studies.Methods: Between Oct 2005 to March 2009, 93 unilateral CSDH patients (mean age 71±11 years) were enrolled for analysis. The associations between GOS at discharge and the following variables on admission including sex, age, GCS, time interval from injury to emergency room, hematoma site, hematoma thickness, hematoma density, midline shift, ventricular sizes (Evan's index and maximum diameter of third ventricle-3Vmax. D), and cortical atrophy on brain CT were evaluated.Results: By multiple logistic regression statistics, the adjusted odds ratio (OR) in predicting the poor outcome was significant with GCS ＜15 [OR=11.2, CI=1.3-96.9, p=0.028] and mixed density hematoma on brain CT [OR=7.4, CI=1.8-31.7, p=0.007]. Using Receiver-Operating Characteristic (ROC) curve, the sensitivity was 73% and the specificity was 85%.Conclusions: In our preliminary study that mixed hematoma density and lower GCS were associated with poor prognosis in unilateral CSDH with sensitive prediction.",

author = "Kuo, {Jinn Rung} and Wang, {Che Chuan} and Huan-Fang Lee and Chung-Ching Chio and Lin, {Kao Chang}",

year = "2010",

month = aug,

day = "1",

language = "English",

volume = "11",

pages = "90--97",

journal = "中華民國重症醫學雜誌＝ Taiwan Critical Care Medicine",

issn = "1563-356X",

number = "2",

}

TY - JOUR

T1 - Hematoma Density and Glasgow Coma Scale are Independent Predictors to Outcomes in Unilateral Chronic Subdural Hematoma

AU - Kuo, Jinn Rung

AU - Wang, Che Chuan

AU - Lee, Huan-Fang

AU - Chio, Chung-Ching

AU - Lin, Kao Chang

PY - 2010/8/1

Y1 - 2010/8/1

N2 - Introduction: The relationships between Glasgow Outcome Scale (GOS), Glasgow Coma Scale (GCS) and brain computerized tomography (CT) with unilateral chronic subdural hematoma (CSDH) are not consistent in studies.Methods: Between Oct 2005 to March 2009, 93 unilateral CSDH patients (mean age 71±11 years) were enrolled for analysis. The associations between GOS at discharge and the following variables on admission including sex, age, GCS, time interval from injury to emergency room, hematoma site, hematoma thickness, hematoma density, midline shift, ventricular sizes (Evan's index and maximum diameter of third ventricle-3Vmax. D), and cortical atrophy on brain CT were evaluated.Results: By multiple logistic regression statistics, the adjusted odds ratio (OR) in predicting the poor outcome was significant with GCS ＜15 [OR=11.2, CI=1.3-96.9, p=0.028] and mixed density hematoma on brain CT [OR=7.4, CI=1.8-31.7, p=0.007]. Using Receiver-Operating Characteristic (ROC) curve, the sensitivity was 73% and the specificity was 85%.Conclusions: In our preliminary study that mixed hematoma density and lower GCS were associated with poor prognosis in unilateral CSDH with sensitive prediction.

AB - Introduction: The relationships between Glasgow Outcome Scale (GOS), Glasgow Coma Scale (GCS) and brain computerized tomography (CT) with unilateral chronic subdural hematoma (CSDH) are not consistent in studies.Methods: Between Oct 2005 to March 2009, 93 unilateral CSDH patients (mean age 71±11 years) were enrolled for analysis. The associations between GOS at discharge and the following variables on admission including sex, age, GCS, time interval from injury to emergency room, hematoma site, hematoma thickness, hematoma density, midline shift, ventricular sizes (Evan's index and maximum diameter of third ventricle-3Vmax. D), and cortical atrophy on brain CT were evaluated.Results: By multiple logistic regression statistics, the adjusted odds ratio (OR) in predicting the poor outcome was significant with GCS ＜15 [OR=11.2, CI=1.3-96.9, p=0.028] and mixed density hematoma on brain CT [OR=7.4, CI=1.8-31.7, p=0.007]. Using Receiver-Operating Characteristic (ROC) curve, the sensitivity was 73% and the specificity was 85%.Conclusions: In our preliminary study that mixed hematoma density and lower GCS were associated with poor prognosis in unilateral CSDH with sensitive prediction.

M3 - Article

SN - 1563-356X

VL - 11

SP - 90

EP - 97

JO - 中華民國重症醫學雜誌＝ Taiwan Critical Care Medicine

JF - 中華民國重症醫學雜誌＝ Taiwan Critical Care Medicine

IS - 2

ER -

Hematoma Density and Glasgow Coma Scale are Independent Predictors to Outcomes in Unilateral Chronic Subdural Hematoma

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