当前位置: X-MOL 学术Neurosurg. Rev. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Predictors of future haemorrhage from cerebral cavernous malformations: a retrospective cohort study
Neurosurgical Review ( IF 2.5 ) Pub Date : 2023-02-10 , DOI: 10.1007/s10143-023-01949-x
Conor S Gillespie 1, 2 , Khalifa E Alnaham 2 , George E Richardson 1, 2 , Mohammad A Mustafa 1, 2 , Basel A Taweel 1, 2 , Abdurrahman I Islim 2, 3 , Cathal John Hannan 2, 3 , Emmanuel Chavredakis 2
Affiliation  

Cerebral cavernous malformations (CCMs) are commonly diagnosed, with a low reported rate of haemorrhage on long-term follow-up. The identification of factors predictive of future haemorrhage risk would assist in guiding the management of patients with CCM. The aim of this study was to identify variables associated with haemorrhage, and calculate haemorrhage risk in CCM. We conducted a retrospective study of patients diagnosed with a CCM, managed at a specialist tertiary neuroscience centre (2007–2019). The primary outcome was symptomatic haemorrhage, and secondary outcomes were variables associated with increased risk of haemorrhage, using multivariable Cox regression analysis. Included were 545 patients, with 734 confirmed cavernomas. Median age at diagnosis was 47 (interquartile range [IQR] 35–60), with a median follow-up duration after diagnosis of 46 months (IQR 19–85). Of the patients, 15.0% had multiple lesions (N = 82/545). Symptomatic presentation was observed in 52.5% of patients (N = 286/545). The annual haemorrhage rate was 1.00% per lesion-year (25 events in 2512 lesion-years), and higher in those with symptoms at presentation (1.50% per lesion-year, 22 events vs 0.29%, 3 events, P < 0.001). The variables associated with symptomatic haemorrhage were increased size (hazard ratio [HR] 1.04, 95% confidence interval [CI] 1.01–1.07, P = 0.004), eloquent location (HR 2.63, 95% CI 1.12–6.16, P = 0.026), and symptomatic haemorrhage at presentation (HR 5.37, 95% CI 2.40–11.99, P < 0.001). This study demonstrated that CCMs have a low haemorrhage rate. Increased size, eloquent location, and haemorrhage at presentation appear to be predictive of a higher risk of haemorrhage, and could be used to stratify management protocols.



中文翻译:


脑海绵状血管瘤未来出血的预测因素:一项回顾性队列研究



脑海绵状血管瘤 (CCM) 是常见的诊断方法,但长期随访中报告的出血率较低。识别未来出血风险的预测因素将有助于指导 CCM 患者的治疗。本研究的目的是确定与出血相关的变量,并计算 CCM 的出血风险。我们对在专业三级神经科学中心管理的诊断为 CCM 的患者进行了回顾性研究(2007-2019 年)。使用多变量 Cox 回归分析,主要结局是症状性出血,次要结局是与出血风险增加相关的变量。其中包括 545 名患者,其中 734 名确诊海绵状血管瘤。诊断时的中位年龄为 47 岁(四分位距 [IQR] 35-60),诊断后的中位随访时间为 46 个月(IQR 19-85)。在患者中,15.0%有多个病变( N = 82/545)。 52.5% 的患者出现症状( N = 286/545)。年出血率为每个病灶年 1.00%(2512 个病灶年中发生 25 起事件),出现症状的患者出血率更高(每个病灶年 1.50%,22 起事件 vs 0.29%,3 起事件, P < 0.001) 。与症状性出血相关的变量包括体积增大(风险比 [HR] 1.04,95% 置信区间 [CI] 1.01–1.07, P = 0.004)、雄辩位置(HR 2.63,95% CI 1.12–6.16, P = 0.026) ,以及就诊时出现症状性出血(HR 5.37,95% CI 2.40–11.99, P < 0.001)。这项研究表明 CCM 的出血率较低。 增大的体型、明显的位置和就诊时的出血似乎预示着较高的出血风险,并且可用于对管理方案进行分层。

更新日期:2023-02-10
down
wechat
bug