脳内出血患者における全身合併症 : 特に肺炎の検討

概要

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To clarify the effects of systemic complications on the outcome of patients with spontaneous intracerebral hemorrhage (ICH), we studied 201 patients retrospectively to collect information on the severity of ICH and the clinical courses, as well as on systemic complications such as pneumonia, cardiac episodes, gastrointestinal complication, liver damage, renal impairment and urinary tract infection. We then statistically analyzed those factors in relation to the patients' back- grounds and outcomes. Pneumonia was the most frequent cause of death in patients with moderate ICH severity, and it was significantly correlated with patients' age, Glasgow Coma Scale (GCS) on admission, the maximum diameter of ICH, and the National Institute for Health Stroke Scale (NIHSS) 1 month after ICH. Lethal pneumonia tended to occur within the acute phase of ICH, and death by pneumonia was usually observed in the subacute or early chronic phase, compared with death by ICH (acute phase) or by other causes (late in the chronic phase). In addition, patients who had suffered from pneumonia were significantly more likely to have other medical complications than were patients without pneumonia. A great deal of attention should be paid to the management of pneumonia, especially in high-risk patients or patients manifesting clinical signs of pneumonia in the acute phase of ICH.
日本脳卒中の外科学会の論文
2003-11-30