Influencing factors of cerebral infarction in elderly patients with hypertensive intracerebral hemorrhage after hematoma clearance / 中华行为医学与脑科学杂志

ABSTRACT

Objective To investigate the influencing factors of cerebral infarction in elderly patients with hypertensive intracerebral hemorrhage after hematoma clearance.Methods A total of 197 elderly patients with hypertensive intracerebral hemorrhage were selected and treated with craniotomy hematoma removal and decompression of bone flap.Cerebral infarction was checked by craniocerebral CT after operation.Univariate and multivariate Logistic regression analysis was used to identify the independent risk factors for cerebral infarction.Results The incidence of cerebral infarction after hematoma clearance in hypertensive intracerebral hemorrhage was 26.90％(53/197).There was no significant difference in the incidence of cerebral infarction after hematoma clearance in hypertensive intracerebral hemorrhage on gender and age (P＞ 0.05),while the differences were statistically significant in diabetes (x2 =7.986),hypertension history (x2 =10.399),hematoma volume(x2=10.396),edema(x2=12.436),systolic blood pressure(x2 =12.128),diastolic blood pressure(x2 =13.040) and GCS score(x2 =3.940) (all P＜0.05).Logistic regression analysis showed that history of diabetes mellitus(β=1.472,0R=2.174,95％CI=1.092-2.981),history of hypertension (β =1.894,OR =2.819,95 ％ CI =1.309-3.973),volume of hematoma ＞ 35 ml (β =2.36 l,OR =3.890,95％CI=1.792-5.132),area of brain edema (＞ 65 cm3) (β=2.471,OR=4.321,95％CI=1.879-5.487),systolic pressure (＞ 150 mm Hg,1 mmHg =0.133 kPa) (β=2.073,OR=3.172,95％ CI=1.428-4.768),diastolic pressure (＞ 90 mm Hg) (β=1.715,OR=2.498,95％ CI =1.276-3.451) and GCS score ＜ 8 (β=2.592,OR=4.871,95％ CI=1.974-5.798)were independent risk factors for cerebral infarction after hematoma clearance in hypertensive intracerebral hemorrhage.Conclusion Elderly patients with cerebral infarction after hematoma clearance in hypertensive intracerebral hemorrhage is affected by diabetes mellitus,hypertension,hematoma volume,edema,systolic blood pressure,diastolic blood pressure and other factors.Early intervention on these factors may effectively reduce the incidence of cerebral infarction.