Prediction of stress-related gastrointestinal bleeding in patients with aneurysmal subarachnoid hemorrhage using caudate Hounsfield unit value in ASPECT score

Frontiers in Neurology

Neurology

Yahui Zhao¹  Fa Lin¹  Tu Li¹  Yitong Jia¹  Kexin Yuan¹  Jun Yang¹  Yu Chen¹  Ke Wang¹  Yunfan Zhou¹  Zhipeng Li¹  Runting Li¹  Haibin Zhang¹  Heze Han¹  Ruinan Li¹  Xiaolin Chen²  Qiang Hao²  Yuanli Zhao³ 

[1] Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;Stroke Center, Beijing Institute for Brain Disorders, Beijing, China;Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China;Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;Stroke Center, Beijing Institute for Brain Disorders, Beijing, China;Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China;China National Clinical Research Center for Neurological Diseases, Beijing, China;

关键词: aneurysmal subarachnoid hemorrhage;    stress-related gastrointestinal bleeding;    ASPECT score;    Hounsfield units;    caudate;   

DOI  :  10.3389/fneur.2023.1237310

 received in 2023-06-09, accepted in 2023-08-14,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundStress-related gastrointestinal bleeding (SRGB) is one of the major complications after aneurysmal subarachnoid hemorrhage (aSAH), and it can present challenges in patient care and treatment. The aim of this study was to explore the clinical significance of the caudate Hounsfield unit (HU) value in the Alberta Stroke Program Early CT (ASPECT) score for predicting SRGB in patients with aSAH.MethodsWe retrospectively analyzed the data of 531 aSAH patients admitted to our institution between 2019 and 2022. Potential predictors of SRGB were identified using multivariate Cox regression analysis. We used a restricted cubic spline (RCS) to evaluate whether there is a nonlinear relationship between the right caudate HU value and SRGB. MaxStat analysis (titled as maximally selected rank statistics) was performed to identify the optimal cutoff point for the right caudate HU value. Another Kaplan–Meier method with the log-rank test was used to analyze the right caudate HU value in predicting the occurrence of SRGB.ResultsThe incidence rate of SRGB was 17.9%. In the multivariate Cox regression analysis, the right caudate HU value was an independent predictor of SRGB [Hazard ratio (HR) = 0.913; 95% confidence interval (CI): 0.847–0.983, and p = 0.016]. The RCS indicated that the incidence of developing SRGB reduces with increasing right caudate HU values (nonlinear p = 0.78). The optimal cut-off value of the right caudate HU was 25.1.ConclusionAmong aSAH patients, lower right caudate HU values indicated a higher risk of developing SRGB. Our findings provide further evidence for the relationship between the gastrointestinal system and the brain.

【 授权许可】

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Copyright © 2023 Wang, Yuan, Li, Lin, Chen, Yang, Han, Li, Jia, Zhou, Zhang, Li, Li, Zhao, Hao, Chen and Zhao.