BACKGROUND AND PURPOSE Paroxysmal sympathetic hyperactivity (PSH) is a rare complication of spontaneous intracerebral hemorrhage (ICH).We aimed to evaluate the risk factors and clinical features for PSH after ICH. METHODS From January 1, 2013 to April 1, 2018, patients with ICH were consecutively included in this observational study. Baseline characteristics were compared in patients with and without PSH. Multivariate logistic regression analysis was used to determine the risk factors associated with PSH development. Clinical features of patients with PSH were also analyzed. RESULTS There were 548 patients with ICH included and a total of 15 (2.7%) patients were identified with PSH. In univariate analysis, PSH development was associated with the following: previous hemorrhagic stroke, pupils abnormity, admission Glasgow Coma Scale (GCS) score, hematoma volume, liver function abnormity, neutrophil count and early tracheostomy. Multivariate logistic regression analysis showed that a significantly increased risk of PSH was found in patients with previous hemorrhagic stroke (odds ratio [OR], 4.176; 95% confidence interval [CI], 1.111-15.698), admission GCS score (OR, 0.703; 95% CI, 0.548-0.902) and early tracheostomy (OR, 8.317; 95%CI, 1.755-39.412).The most common symptoms of PSH were hyperthermia (80%) and hyperhidrosis (80%).The median Intensive Care Unit stays and Glasgow Outcome Scale at discharge were 34 (19-46) and 2 (1.5-3), respectively. CONCLUSIONS PSH is characterized by a cluster of symptoms and abnormal vital signs, which may lead to poor outcomes in ICH. The present study suggests that previous hemorrhagic stroke, admission GCS score and early tracheostomy may be the significant risk factors for PSH after ICH.

中文翻译：

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自发性脑出血后阵发性交感神经亢进的危险因素及临床特征


背景与目的阵发性交感神经亢进（PSH）是自发性脑出血（ICH）的罕见并发症。我们旨在评估ICH后PSH的危险因素和临床特征。方法 2013年1月1日至2018年4月1日连续纳入ICH患者。比较患有和不患有 PSH 的患者的基线特征。使用多变量逻辑回归分析来确定与 PSH 发展相关的危险因素。还分析了 PSH 患者的临床特征。结果 纳入 548 例 ICH 患者，总共 15 例 (2.7%) 患者确诊为 PSH。在单变量分析中，PSH的发展与以下因素相关：既往出血性中风、瞳孔异常、入院格拉斯哥昏迷量表（GCS）评分、血肿量、肝功能异常、中性粒细胞计数和早期气管切开术。多变量逻辑回归分析显示，既往有出血性卒中的患者发生 PSH 的风险显着增加（比值比 [OR]，4.176；95% 置信区间 [CI]，1.111-15.698）、入院 GCS 评分（OR，0.703；95% 置信区间 [CI]，1.111-15.698）。 95% CI, 0.548-0.902) 和早期气管切开术 (OR, 8.317; 95% CI, 1.755-39.412)。PSH 最常见的症状是高热 (80%) 和多汗症 (80%)。重症监护室住院时间中位数出院时的格拉斯哥结果量表分别为 34 (19-46) 和 2 (1.5-3)。结论 PSH 的特点是一系列症状和异常生命体征，这可能导致 ICH 的不良结局。本研究表明，既往出血性卒中、入院 GCS 评分和早期气管切开术可能是 ICH 后发生 PSH 的重要危险因素。