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Risk factors and clinical features of paroxysmal sympathetic hyperactivity after spontaneous intracerebral hemorrhage.
Auton Neurosci. 2020 Jan 27; 225:102643.AN

Abstract

BACKGROUND AND PURPOSE

Paroxysmal sympathetic hyperactivity (PSH) is a rare complication of spontaneous intracerebral hemorrhage (ICH).We aimed to evaluate the risk factors and clinical features for PSH after ICH.

METHODS

From January 1, 2013 to April 1, 2018, patients with ICH were consecutively included in this observational study. Baseline characteristics were compared in patients with and without PSH. Multivariate logistic regression analysis was used to determine the risk factors associated with PSH development. Clinical features of patients with PSH were also analyzed.

RESULTS

There were 548 patients with ICH included and a total of 15 (2.7%) patients were identified with PSH. In univariate analysis, PSH development was associated with the following: previous hemorrhagic stroke, pupils abnormity, admission Glasgow Coma Scale (GCS) score, hematoma volume, liver function abnormity, neutrophil count and early tracheostomy. Multivariate logistic regression analysis showed that a significantly increased risk of PSH was found in patients with previous hemorrhagic stroke (odds ratio [OR], 4.176; 95% confidence interval [CI], 1.111-15.698), admission GCS score (OR, 0.703; 95% CI, 0.548-0.902) and early tracheostomy (OR, 8.317; 95%CI, 1.755-39.412).The most common symptoms of PSH were hyperthermia (80%) and hyperhidrosis (80%).The median Intensive Care Unit stays and Glasgow Outcome Scale at discharge were 34 (19-46) and 2 (1.5-3), respectively.

CONCLUSIONS

PSH is characterized by a cluster of symptoms and abnormal vital signs, which may lead to poor outcomes in ICH. The present study suggests that previous hemorrhagic stroke, admission GCS score and early tracheostomy may be the significant risk factors for PSH after ICH.

Authors+Show Affiliations

Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China. Electronic address: lvlq1976@163.com.Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China. Electronic address: lijunhoucz@126.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32097879

Citation

Li, Zhenxing, et al. "Risk Factors and Clinical Features of Paroxysmal Sympathetic Hyperactivity After Spontaneous Intracerebral Hemorrhage." Autonomic Neuroscience : Basic & Clinical, vol. 225, 2020, p. 102643.
Li Z, Chen W, Zhu Y, et al. Risk factors and clinical features of paroxysmal sympathetic hyperactivity after spontaneous intracerebral hemorrhage. Auton Neurosci. 2020;225:102643.
Li, Z., Chen, W., Zhu, Y., Han, K., Wang, J., Chen, J., Zhang, D., Yu, M., Lv, L., & Hou, L. (2020). Risk factors and clinical features of paroxysmal sympathetic hyperactivity after spontaneous intracerebral hemorrhage. Autonomic Neuroscience : Basic & Clinical, 225, 102643. https://doi.org/10.1016/j.autneu.2020.102643
Li Z, et al. Risk Factors and Clinical Features of Paroxysmal Sympathetic Hyperactivity After Spontaneous Intracerebral Hemorrhage. Auton Neurosci. 2020 Jan 27;225:102643. PubMed PMID: 32097879.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors and clinical features of paroxysmal sympathetic hyperactivity after spontaneous intracerebral hemorrhage. AU - Li,Zhenxing, AU - Chen,Wen, AU - Zhu,Yibai, AU - Han,Kaiwei, AU - Wang,Junyu, AU - Chen,Jigang, AU - Zhang,Danfeng, AU - Yu,Mingkun, AU - Lv,Liquan, AU - Hou,Lijun, Y1 - 2020/01/27/ PY - 2019/08/01/received PY - 2020/01/21/revised PY - 2020/01/24/accepted PY - 2020/2/26/pubmed PY - 2020/2/26/medline PY - 2020/2/26/entrez KW - Clinical features KW - Paroxysmal sympathetic hyperactivity KW - Risk factors KW - Spontaneous intracerebral hemorrhage SP - 102643 EP - 102643 JF - Autonomic neuroscience : basic & clinical JO - Auton Neurosci VL - 225 N2 - BACKGROUND AND PURPOSE: Paroxysmal sympathetic hyperactivity (PSH) is a rare complication of spontaneous intracerebral hemorrhage (ICH).We aimed to evaluate the risk factors and clinical features for PSH after ICH. METHODS: From January 1, 2013 to April 1, 2018, patients with ICH were consecutively included in this observational study. Baseline characteristics were compared in patients with and without PSH. Multivariate logistic regression analysis was used to determine the risk factors associated with PSH development. Clinical features of patients with PSH were also analyzed. RESULTS: There were 548 patients with ICH included and a total of 15 (2.7%) patients were identified with PSH. In univariate analysis, PSH development was associated with the following: previous hemorrhagic stroke, pupils abnormity, admission Glasgow Coma Scale (GCS) score, hematoma volume, liver function abnormity, neutrophil count and early tracheostomy. Multivariate logistic regression analysis showed that a significantly increased risk of PSH was found in patients with previous hemorrhagic stroke (odds ratio [OR], 4.176; 95% confidence interval [CI], 1.111-15.698), admission GCS score (OR, 0.703; 95% CI, 0.548-0.902) and early tracheostomy (OR, 8.317; 95%CI, 1.755-39.412).The most common symptoms of PSH were hyperthermia (80%) and hyperhidrosis (80%).The median Intensive Care Unit stays and Glasgow Outcome Scale at discharge were 34 (19-46) and 2 (1.5-3), respectively. CONCLUSIONS: PSH is characterized by a cluster of symptoms and abnormal vital signs, which may lead to poor outcomes in ICH. The present study suggests that previous hemorrhagic stroke, admission GCS score and early tracheostomy may be the significant risk factors for PSH after ICH. SN - 1872-7484 UR - https://www.unboundmedicine.com/medline/citation/32097879/Risk_factors_and_clinical_features_of_paroxysmal_sympathetic_hyperactivity_after_spontaneous_intracerebral_hemorrhage L2 - https://linkinghub.elsevier.com/retrieve/pii/S1566-0702(19)30189-4 DB - PRIME DP - Unbound Medicine ER -
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