ABSTRACT
Determinar la asociación entre hiperglicemia y pronóstico de pacientes con Ictus Hemorrágico Intraparenquimatoso, evaluando la gravedad, discapacidad, complicaciones y mortalidad. Estudio de tipo correlacional, de cohorte histórica, en el Hospital Del Este Dr. Domingo Luciani, en 233 pacientes que ingresaron entre Marzo 2006 y Septiembre 2008. Las pruebas estadísticas utilizadas para el análisis de los resultados fueron: prueba exacta de Fisher; chi-cuadrado de Pearson, U de Mann-Whitney y Kruskal-Wallis. Se observó una correlación directa entre niveles de hiperglicemia y puntuación de la escala de gravedad de NIHSS, no significativa estadísticamente. No se evidenció correlación entre hiperglicemia al ingreso y escala de discapacidad de Rankin. La complicación más frecuentemente encontrada fueron las infecciones respiratorias. La hiperglicemia constituye un marcador de mal pronóstico intrahospitalario en los pacientes con Ictus Hemorrágico Intraparenquimatoso, por su asociación a complicaciones infecciosas.
To determine if there was an association between hyperglycemia and the prognosis of intraparenquimatous hemorrhagic stroke by assesing severity, discapacity, complications and mortality. Correlacional study done at the Hospital Del Este Dr. Domingo Luciani, Caracas, Venezuela with a sample of 233 patients between March 2006 and September 2008. The statistics applied were Fishers exact test, Pearson`s square-chi, Mann-Whitney U and Kruskal-Wallis. A direct correlation between levels of hyperglycemia and NIHSS score was found, but with no stastitical significance. Neither did we find a correlation between admission hyperglycemia and the discapacity Rankin ìs score. Respiratory infections were the most frequent complication. Hyperglycemia is a marker of adverse prognosis in patients with acute hemorrhagic stroke, due to it`s asociation to infectious complications.
Subject(s)
Humans , Male , Female , Stroke/complications , Stroke/diagnosis , Hyperglycemia/pathology , Mental Status Schedule , Hemorrhagic Disorders/pathology , Biomarkers , Internal MedicineABSTRACT
We conducted a retrospective study to investigate the incidence, risk factors, and clinical features of hemorrhagic cystitis (HC) following allogeneic hematopoietic cell transplantation (allo-HCT). Adult patients who developed HC after allo-HCT were identified from the HCT database of the Asan Medical Center and their medical records were reviewed. From December 1993 to August 2001, a total of 210 adult patients underwent allo-HCT. Fifty-one patients developed HC with a cumulative incidence of 25.7%. The median onset of HC was post-transplant day 24 (range, -2 to 474), and the median duration was 31 days (range, 8 to 369). Significant risk factors for HC by univariate analysis included diagnosis of chronic myelogenous leukemia (p=0.028), unrelated HCT (p=0.029), grade III-IV acute graft-versus-host disease (GVHD) (p<0.001), extensive chronic GVHD (p=0.001), and positive cytomegalovirus antigenemia between post transplant days 31 and 60 (p=0.031). Multivariate analysis showed that grade III-IV acute GVHD was the most important risk factor for the occurrence of HC after allo-HCT (odds ratio, 3.38; 95% CI, 1.36-8.39). Late-onset HC, which occurred beyond 3 weeks after allo-HCT, was more frequently associated with GVHD than earlyonset HC (p=0.007). Our data suggest that a portion of late-onset HC might be a manifestation of GVHD.