ABSTRACT

Purpose

The Alberta Stroke Program Early CT Score (ASPECTS) is widely used to guide thrombolytic therapy and predict the functional outcome of patients with acute ischemic stroke (AIS). Whether ASPECTS can predict the functional outcome of patients with intracerebral hemorrhage (ASPECTS-H) remains unclear.

Methods

Patients with primary intracerebral hemorrhage (ICH) were collected and retrospectively analyzed. ASPECTS-H was assessed at admission. Patients were followed up at 30 days and 90 days after the onset of ICH. Occurrence of death within 90 days after ICH was the primary endpoint. Modified Rankin Scale (mRS) ≥ 3 was considered a poor functional outcome.

Results

A total of 149 patients met eligibility criteria; 61 (40.9%) had poor functional outcome at 30 days, and 37 (24.8%) had poor functional outcome at 90 days. Using binary logistic regression modeling, we found that a low ASPECTS-H was associated with a poor functional outcome. The risk ratio of a low ASPECTS-H was 2.31 at 30 days (P = 0.000; 95% CI, 1.560–3.421) and 2.711 at 90 days (P = 0.000; 95% CI, 1.677–4.381). The optimal cutoff value of ASPECTS-H to discriminate good and poor 30-day and 90-day outcomes was 7.5 (Sensitivity_30-day = 0.636, 1-Specificity_{30 – day} = 0.311; Sensitivity_90-day = 0.580, 1-Specificity_90-day = 0.270).

Conclusions

A low ASPECTS-H was an indicator of poor short-term and long-term functional outcomes of ICH.

中文翻译：

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局灶性脑出血患者的 ASPECT 评分与其短期和中期功能结果相关

摘要

目的

阿尔伯塔省卒中计划早期 CT 评分 (ASPECTS) 广泛用于指导溶栓治疗和预测急性缺血性卒中 (AIS) 患者的功能结果。ASPECTS 能否预测脑出血（ASPECTS-H）患者的功能结果仍不清楚。

方法

收集原发性脑出血（ICH）患者并进行回顾性分析。入院时评估 ASPECTS-H。在 ICH 发作后 30 天和 90 天对患者进行随访。ICH 后 90 天内发生死亡是主要终点。改良 Rankin 量表 (mRS) ≥ 3 被认为是不良的功能结果。

结果

共有 149 名患者符合入选标准；61 人（40.9%）在 30 天时功能结果不佳，37 人（24.8%）在 90 天时功能结果不佳。使用二元逻辑回归模型，我们发现低 ASPECTS-H 与较差的功能结果相关。低 ASPECTS-H 的风险比在 30 天时为 2.31（P = 0.000；95% CI，1.560-3.421），在 90 天时为 2.711（P = 0.000；95% CI，1.677-4.381）。ASPECTS-H 区分 30 天和 90 天结果好坏的最佳截止值为 7.5（敏感性_{30 天} = 0.636，1-特异性_{30 - 天} = 0.311；敏感性_{90 天} = 0.580，1-特异性_{90 天} = 0.270）。

结论

低 ASPECTS-H 是 ICH 短期和长期功能结果不佳的指标。