保健医学研究与实践2025，Vol.22Issue(1)：34-40,7.DOI:10.11986/j.issn.1673-873X.2025.01.06
基底节区高血压脑出血患者预后的危险因素及风险预测模型构建
Risk factors influencing prognosis in patients with hypertensive intracerebral hemorrhage in the basal ganglia region and development of a predictive model
摘要
Abstract
Objective To investigate the risk factors influencing the prognosis of patients with hypertensive intracerebral hemorrhage(HICH)in the basal ganglia region and to develop a predictive model for their prognosis,aiming to provide ref-erences for clinical treatment.Methods A total of 202 patients diagnosed with HICH in the basal ganglia region at our hos-pital from March 2021 to April 2024 were enrolled.Based on their 3-month postoperative outcomes,patients were allocated to a good prognosis group(n=143)and a poor prognosis group(n=59).Clinical data were collected,and multivariate lo-gistic regression analysis was performed to identify factors affecting prognosis.Receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of the established model.Results In the poor prognosis group,the proportions of patients aged≥60 years,with a history of diabetes,hypertension duration≥10 years,Glasgow Coma Scale(GCS)score upon admission 3-8 points,hematoma volume≥30 mL,intraventricular hemorrhage,midline shift≥1 cm,timing of surgery(≥6 hours),and 24 h-postoperative complications(≥2 types)were significantly higher compared to the good prognosis group.Additionally,systolic blood pressure(SBP),white blood cell count(WBC),low-density lipoprotein cholesterol(LDL-C),and D-dimer(D-D)levels upon admission were significantly higher in the poor prognosis group(P<0.05).Multivariate logistic regression analysis revealed that GCS score upon admission 3-8 points,hematoma volume≥30 mL,intraventricular hemorrhage,midline shift≥1 cm,timing of surgery(≥6 hours),24 h-postoperative complications(≥2 types),and elevated D-D levels were independent risk factors for poor prognosis in these patients(P<0.05).The ROC curve for the predictive model indicated that when logit(P)>10,the area under the curve(AUC)was 0.867(95%CI:0.815-0.919),with a specificity of 68.49%and sensitivity of 90.77%.Conclusion Risk factors affecting the prog-nosis of patients with HICH in the basal ganglia region include GCS score upon admission 3-8 points,hematoma volume≥30 mL,intraventricular hemorrhage,midline shift≥1 cm,timing of surgery(≥6 hours),24 h-postoperative complications(≥2 types)and elevated D-D levels.The predictive model developed based on these factors demonstrates good predictive value for patient prognosis.关键词
基底节区/高血压脑出血/预后/预测模型Key words
Basal ganglia region/Hypertensive intracerebral hemorrhage/Prognosis/Predictive model分类
临床医学引用本文复制引用
王茵,王毓,赵静,李怡欣,张晓红,余玮,王思怡,赵荣..基底节区高血压脑出血患者预后的危险因素及风险预测模型构建[J].保健医学研究与实践,2025,22(1):34-40,7.基金项目
陕西省自然科学基础研究计划项目(2022JM-437). （2022JM-437）
