The predictive value of the Glasgow-Pupil score combined with lactate in the prognosis of patients with spontaneous intracerebral hemorrhage
10.3760/cma.j.issn.1671-0282.2024.11.016
- VernacularTitle:格拉斯哥-瞳孔评分联合乳酸对自发性脑出血患者预后的预测价值
- Author:
Tengyu CHE
1
;
Lei LYU
;
Xin HE
;
Jie CHENG
;
Xu ZHAO
Author Information
1. 华北理工大学研究生学院，唐山 063000
- Keywords:
Spontaneous intracerebral hemorrhage;
Emergency;
GCS-P score;
Arterial lactate;
Prognosis
- From:
Chinese Journal of Emergency Medicine
2024;33(11):1566-1571
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive value of Glasgow coma scale-pupil (GCS-P) score combined with arterial lactate level on 30-day mortality in patients with spontaneous intracerebral hemorrhage (sICH).Methods:Patients with sICH attended to the emergency department of the Affiliated Hospital of North China University of Science and Technology from January 2021 to September 2023 were respectively collected. The patients were divided into survival group and death group according to survival outcome at 30 d after the onset of the disease. The data of the patients between the two groups were compared, including basic data, vital signs on admission to the hospital, pupils status, laboratory indexes, emergency Glasgow coma scale (GCS) scores, and other clinical data. The binary logistic regression analysis was used to analyze the risk factors affecting the poor prognosis of sICH patients, and LASSO regression analysis was used for further validation. The receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of the emergency GCS-P score combined with the lactate level score on the mortality rates of sICH patients.Results:A total of 512 patients were included, 235 in the survival group and 277 in the death group. The admission heart rate, blood glucose, arterial lactate level, and the proportion of patients with hypertension and stroke were significantly higher in the death group than in the survival group, and the GCS score and emergency GCS-P score were significantly lower than those in the survival group (all P<0.05). For the mortality analysis of sICH patients at different levels, the mortality rate of patients with very severe GCS-P was significantly higher than that of patients with severe disease ( P<0.05), However, there was no significant difference in GCS between the two groups ( P>0.05). Binary logistic regression analysis showed that emergency GCS-P score ( OR=1.400, 95% CI: 1.297-1.512, P<0.001) and arterial lactate level ( OR=0.674, 95% CI: 0.567-0.800, P<0.001) were predicted factors for the prognosis of patients with sICH. ROC curve analysis showed that the area under the curve of GCS, GCS-P, arterial lactate, and GCS-P combined with arterial lactate to predict the prognosis of patients was 0.748, 0.783, 0.718, and 0.819, respectively. Among them, GCS-P score combined with arterial lactate had the best prediction effect. Conclusion:GCS-P combined with arterial lactate levels could be used to predict the prognosis of sICH patients
