Prognostic factors of postoperative patients with intracerebral hemorrhage and application of event-related potentials in consciousness monitoring
10.3969/j.issn.1002-0152.2024.04.002
- VernacularTitle:脑出血预后危险因素及事件相关电位在意识监测中的应用
- Author:
Mengmeng HE
1
;
Chen CHU
;
Jianling GAO
Author Information
1. 苏州大学附属第四医院重症医学科(苏州 215000)
- Keywords:
Postoperative cerebral hemorrhage;
Mismatch negativity(MMN);
Risk factors;
Consciousness;
ROC curve
- From:
Chinese Journal of Nervous and Mental Diseases
2024;50(4):209-214
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the risk factors of prognosis of patients with intracerebral hemorrhage at 6 months after operation,and to study the diagnostic efficacy of event-related potential(ERP)on outcome and prognosis.Methods Forty postoperative patients with intracerebral hemorrhage were prospectively enrolled.The age,sex,preoperative blood loss and GCS were collected.The mismatch negative wave(MMN)was measured by ERP on the 1st,3rd,7th and 14th day after operation,and the modified coma recovery scale(CRS-R)was evaluated simultaneously.The Glasgow outcome scale(GOS)of patients was assessed by telephone follow-up after 6 months GOS 1～2 and 3～5 was defined as poor prognosis and good prognosis.,respectively.Multivariate Logistic regression analysis was used to analyze the risk factors affecting the outcome and prognosis of patients,to explore the correlation between MMN and CRS-R,and ROC curve was used to evaluate the predictive value of MMN on the prognosis of patients.Results There were significant differences in the preoperative blood loss,admission GCS score and MMN amplitude between patients with good prognosis and those with poor prognosis on the 3rd,7th and 14th day after operation.Multivariate Logistic regression analysis showed that MMN amplitude on the 14th day after operation was an independent risk factor for poor prognosis(OR=0.100,95%CI:0.000～0.355,P<0.05).The amplitude of MMN was strongly correlated with CRS-R and the correlation coefficient was 0.643(P<0.01).The amplitude of MMN on the 14th day after operation had a high diagnostic efficiency for the clinical prognosis at 6 months.Conclusion The lower the amplitude of MMN on the 14th day after operation,the worse the prognosis of patients.ERP monitoring of postoperative disturbance of consciousness in patients with intracerebral hemorrhage is expected to become an effective tool to predict the prognosis of patients.
