ABSTRACT
Objective To investigate the correlation between baseline serum lipid levels and hematoma enlargement in patients with acute intracerebral hemorrhage (ICH). Methods From October 2013 to January 2018, patients with ICH admitted to the Department of Neurosurgery, Heze Municipal Hospital, were enrolled retrospectively. The first CT scan was completed within 6 h after onset, and the second one was completed at 48 h after onset. Hematoma enlargement was defined as an increase >33 % in the volume of hematoma on CT. The demographic and baseline clinical data in the hematoma enlargement group and the non -hematoma enlargement group were compared. Multivariate logistic regression analysis was used to identify the independent risk factors for hematoma enlargement. Results A total of 470 patients with acute ICH were enrolled, including 187 females (39.8%) and 283 males (60.2%), aged 47-81 years. Seventy-nine patients (16.8%) had hematoma enlargement. The proportion of patients with atrial fibrillation and who used warfarin before onset, as well as age, baseline National Institutes of Health Stroke Scale score, baseline hematoma volume, international normalized ratio, prothrombin time, activated partial thromboplastin time, and thrombin time of the hematoma enlargement group were significantly higher than those of the non -hematoma enlargement group ( all P< 0.05 ), while from the onset to the first CT scan time, total cholesterol, triglyceride, low-density lipoprotein cholesterol levels were significantly lower than those in the non- hematoma enlargement group (all P<0.05). Multivariate logistic regression analysis showed that baseline total cholesterol <3.20 mmol/L (odds ratio [ OR] 1.32, 95% confidence interval [ CI] 1.08-1.83; P=0.004), baseline hematoma volume≥30 ml (1.76,95% CI 1.30-2.15; P<0.001), and using anticoagulant before onset ( OR 2.37, 95% CI 1.81-3.02; P<0.001 ) had significantly independent correlation with hematoma enlargement. Conclusion Baseline total cholesterol <3.20 mmol/L, hematoma volume ≥30 ml, and using anticoagulant before onset were the independent risk factors for hematoma enlargement in patients with acute ICH.
ABSTRACT
PURPOSE : To evaluate clinical and three dimensional (3D) dosimetric parameters associated with esophageal injury after radiotherapy for non-small cell lung cancer (NSCLC). MATERIALS AND METHODS : The records of 254 patients treated for NSCLC between 1992 and 2001 were reviewed. A variety of metrics describing the esophageal dose were extracted. Chemotherapy was given in 143 patients (56%). The RTOG toxicity criteria for grading of esophageal injury were used. The median follow-up time of all patients was 43 months with the range of 0.5~120 months. Logistic regression, contingency table analyses and Fisher's exact tests were used for statistical analysis. RESULTS : Acute toxicity occurred in 78% patients (199/254); grade 1,138; grade 2, 38; grade 3, 22 and grade 4, 1. For acute toxicity> or =Grade 2, BID-RT, age, nodal stage> or =N2, and most dosimetric parameters were predictive. Late toxicity occurred in 17 (7%) of 238 patients; grade 1, 5; grade 2, 4; grade 3, 5 and grade 4, 3. The median and maximum time to onset of late toxicity was 5 and 40 months after radiotherapy, respectively. Late toxicity occurred in 2%, 3%, 17%, 26%, and 100% of patients with acute grade 0, 1, 2, 3 and 4 toxicity, respectively. For late toxicity, the severity of acute toxicity was most predictive. CONCLUSION : A variety of dosimetric parameters are predictive for acute and late esophageal injury. A strong correlation between the dosimetric parameters prevented a comparison between the predictive abilities of these metrics. The presence of acute injury was the most predictive factor for the development of late injury. This suggests that late injury may be "consequential" and that aggressive treatment of acute effects may reduce the risk of late injury. Additional studies to better define predictors of RT-induced esophageal injury are needed