机构:[1]Department of Neurology, West China Hospital, Sichuan University, Chengdu, China四川大学华西医院[2]Center of Cerebrovascular Diseases, West China Hospital, Sichuan University, Chengdu, China四川大学华西医院[3]Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, China内科科室外科科室神经内科泌尿外科昆明医科大学附属第一医院
Objectives: To explore the association, if any, between the relationship between cardiac troponin and cerebral herniation after intracerebral hemorrhage (ICH). Methods: Six hundred and eighty-seven consecutive ICH patients admitted to West China Hospital from May 1, 2014 to September 1, 2015 were retrospectively reviewed. Data on demographics, etiology, laboratory examinations at admission including serum cardiac troponin, computed tomography (CT) scans at admission and follow-up, and clinical outcomes were obtained. Using multiple logistic regression to identify the relationship of troponin and herniation. The association between troponin and hematoma volume was assessed using bivariate correlation and linear regression. Results: Among 188 (27.4%) patients who underwent the test of serum cardiac troponin at admission, 16 (8.5%) demonstrated cerebral herniation. The median time from symptom onset to CT at admission and follow-up was 4 and 30.25 hr, respectively. In multivariate analysis, elevated troponin was independently associated with cerebral herniation (adjusted odds ratio [OR] 5.19; 95% confidence interval [CI], 1.08-24.93). And those with elevated troponin had larger hematoma volume at follow- up in bivariate correlation (correlation coefficient,.375, p =.003) and linear regression (beta,.370, 95% CI, 0.062-0.320, p =.005), higher National Institutes of Health Stroke Scale score (adjusted OR 2.06; 95% CI, 1.06-4.01, p =.033) and lower Glasgow Coma Scale score (adjusted OR 2.34; 95% CI, 1.17-4.68, p =.016) than those without. Conclusions: Elevated cardiac troponin was associated with an almost five-fold increased risk of cerebral herniation, but not in-hospital mortality. The possibility of cerebral herniation should be considered when ICH patients with large hematoma volume and elevated troponin.
基金:
National Key Research and Development Program of China; Ministry of Science and Technology of ChinaMinistry of Science and Technology, China [2016YFC1300500-505]; National Key Technology RD ProgramNational Key Technology R&D Program; 12th Five-Year Plan of People's Republic of China [2011BAI08B05]
第一作者机构:[1]Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
通讯作者:
通讯机构:[*1]Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
推荐引用方式(GB/T 7714):
Xu Mangmang,Lin Jing,Wang Deren,et al.Cardiac troponin and cerebral herniation in acute intracerebral hemorrhage[J].BRAIN AND BEHAVIOR.2017,7(6):doi:10.1002/brb3.697.
APA:
Xu, Mangmang,Lin, Jing,Wang, Deren,Liu, Ming,Hao, Zilong&Lei, Chunyan.(2017).Cardiac troponin and cerebral herniation in acute intracerebral hemorrhage.BRAIN AND BEHAVIOR,7,(6)
MLA:
Xu, Mangmang,et al."Cardiac troponin and cerebral herniation in acute intracerebral hemorrhage".BRAIN AND BEHAVIOR 7..6(2017)