ABSTRACT
Objective:To explore the value of Glasgow coma score (GCS) combined with optic nerve sheath diameter (ONSD) in predicting the death risk of patients with cerebrocardiac syndrome (CCS).Methods:From January 2021 to September 2021, 83 patients with CCS secondary to severe traumatic brain injury (sTBI) in our hospital were collected and divided into a survival group ( n = 37) and death group ( n = 46) according to CCS-related death. The clinical data including age, sex, underlying diseases, head CT imaging manifestations, electrolytes, blood glucose, C-reactive protein (CRP), neuron-specific enolase (NSE), lactate dehydrogenase (LDH), creatine kinase (CK), creatine phosphokinase isoenzyme (CKMB), intracranial pressure (ICP), ONSD, cardiac color ultrasound, acute physiology and chronic health evaluationII (APACHEⅡ ) and GCS were analyzed and compared between the two groups. The proportion and dosage of vasoactive drugs used at admission, daily fluid balance volume during hospitalization, total amount of sedative and analgesic drugs, and average daily dose were analyzed and compared between the two groups. The independent risk factors for CCS-related death were analyzed using multivariate logistic regression. The receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of the independent risk factors in CCS-related death. Results:In this study, 55.4% of the patients died of CCS. The ONSD, ICP change rate, right ventricular Tei index and NSE in the death group were higher than those in the survival group, with statistically significant differences ( P < 0.05), while the GCS in the death group was significantly lower than that in the survival group, with a statistically significant difference ( P < 0.01). ONSD ( OR = 23.890, 95% CI: 5.526-103.286, P < 0.001), GCS ( OR = 17.066, 95% CI: 1.476-197.370, P = 0.023) and ICP change rate ( OR = 0.060, 95% CI: 0.007-0.477, P = 0.008) were the independent risk factors for CCS-related death. The area under the ROC curve (AUC = 0.897) of ONSD combined with GCS in evaluating CCS-related death was larger than that of ONSD, ICP change rate alone and the corresponding AUC of 1/GCS (0.876, 0.785, 0.800, respectively), with the advantages of non-invasive, dynamic monitoring and low inspection costs. Conclusions:The mortality rate of CCS is high. ONSD, GCS and ICP change rates are independently correlated with the death of CCS patients. ONSD combined with GCS is an ideal indicator for clinical prediction of CCS-related death.
ABSTRACT
Objective To analyze the cancer mortality and epidemiological characteristics of digestive system cancer in Xianyou County, Fujian Province, and to provide a scientific evidence for formulating preventive measures for digestive system cancer. Methods Excel and SPSS software were used to collect the monitoring data of digestive system cancer death in Xianyou County from 2014 to 2018, and then analyzed the mortality, the standardized rate (according to the Chinese 2000 population census) and the cause of death. Results From 2014 to 2018, the deaths of malignant tumors in Xianyou County accounted for 35.00% of all deaths. Among them, the four common digestive system malignant tumors (gastric cancer, esophageal cancer, liver cancer and colorectal cancer) accounted for 62.44% of malignant tumors. Gastric cancer ranked first and accounted for 27.36%. Average annual rate of crude mortality and standardized mortality of malignant tumor in the digestive system were 108.93/105 and 89.34/105, respectively, and the ratio of male to female was 2.27 to 1. Significant differences were found between town and village, as the terrain gets lower, the death rate goes down gradually. Compared with the data of 2011-2012, the standardized death rate of gastric cancer, esophageal cancer and liver cancer were reduced by 29.71%, 23.92% and 12.06%, respectively, while the rate of colorectal cancer was increased by 28.80% and the average annual growth rate was 7.83%. Conclusion Although the death rates of gastric cancer, esophageal cancer and liver cancer have decreased significantly, the malignant tumor of the digestive system is still the main disease that causes the death of residents in Xianyou County, Putian City. Therefore, it is necessary to strengthen the education of health in order to achieve the early discovery, diagnosis and treatment.