Incidence and Predictors of Angiographic Vasospasm, Symptomatic Vasospasm and Cerebral Infarction in Chinese Patients with Aneurysmal Subarachnoid Hemorrhage

<div><p>Introduction</p><p>Cerebral vasospasm (CVS) is the most common neurological complication after aneurysmal subarachnoid hemorrhage (aSAH) and associated with poor functional outcome and mortality. Reports on incidence and predictors of CVS in Chinese patients with aSAH were scarce. We aimed to estimate the incidence and predictors of angiographic vasospasm (AV), symptomatic vasospasm (SV), and cerebral infarction in Chinese patients with aSAH.</p><p>Methods</p><p>We retrospectively reviewed the medical records of 542 consecutive aSAH patients admitted to neurosurgery department of the First Affiliated Hospital of Xinjiang Medical University in Urumqi city of China between January 1, 2011 and December 31, 2015. AV, SV and cerebral infarction were defined based on clinical data and neuroimaging findings. Univariate and multivariate analyses were performed to identify predictors of AV, SV or cerebral infarction.</p><p>Results</p><p>343 (63.3%) patients fulfilled the inclusion and exclusion criteria. Of them, 182(53.1%) developed AV, 99 (28.9%) developed SV, and 87 (25.4%) developed cerebral infarction. A history of hypertension, poor modified Fisher grade (3–4) and poor Hunt-Hess grade (4–5) on admission were common risk factors for AV, SV and cerebral infarction. Patients from Uyghur ethnic group or other minorities were less likely to develop AV, SV or cerebral infarction, compared to those from Han ethic group after adjustment of other potential confounders. Additionally, age ≥53 years, leukocyte count ≥11× 10⁹/L on admission and being current or former smokers were independent risk factors of cerebral infarction. Leukocyte count ≥11× 10⁹/L on admission and aneurysm size ≥ 10 mm were independent risk factors of SV. Serum glucose level ≥7.0 mmol/L on admission was an independent risk factor of AV.</p><p>Conclusion</p><p>Risk factors of different definitions of CVS were diverse in Chinese patients with aSAH; however, risk factors of SV and cerebral infarction seem to be similar. We recommend early and aggressive therapy in these patients at-risk of CVS.</p></div

Univariate analysis of risk factors associated with occurrence of AV, SV and cerebral infarction in patients with aSAH.

<p>Univariate analysis of risk factors associated with occurrence of AV, SV and cerebral infarction in patients with aSAH.</p

Demographic and clinical characteristics of 343 patients with aSAH on admission.

<p>Demographic and clinical characteristics of 343 patients with aSAH on admission.</p

Flow diagram of the eligible patients and enrollment process of the study.

<p>Flow diagram of the eligible patients and enrollment process of the study.</p

Multivariate analysis of risk factors associated with AV, SV and cerebral infarction in patients with aSAH.

<p>Multivariate analysis of risk factors associated with AV, SV and cerebral infarction in patients with aSAH.</p

Data_Sheet_1_A network approach to investigating the inter-relationship between health-related quality of life dimensions and depression in 1735 Chinese patients with heterogeneous cancers.DOCX

BackgroundWe aimed to explore the inter-connection between depression and HRQOL dimensions in cancer patients using a network approach, which might provide new insights for precise interventions to improve cancer patients’ overall HRQOL.MethodsBetween June 1, 2016, and August 31, 2017, a total of 1735 eligible patients with heterogeneous types of cancer were recruited. The Zung Self-Rating Depression Scale (SDS) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) were used to measure patients’ depression status and HRQOL, respectively. A regularized partial correlation network was established. Central and bridge symptoms/functions were identified using expected influence and bridge expected influence. A directed acyclic graph (DAG) was used to explore the possible causal relationship between depression and HRQOL dimensions.ResultsIn this study, depression and 15 dimensions of the EORTC-QLQ-C30 scale were highly inter-correlated and could be represented as a network. We found that nearly two-thirds of cancer patients experienced various degrees of depression, and depression was consistently the central symptom in the network, in addition to nausea/vomiting, pain, and physical function. DAG and bridge symptoms indicated that depression might influence overall HRQOL in cancer patients mainly through emotional function, pain, physical function, and sleeplessness, particularly in cancer patients with moderate-to-severe depression. The disparity in network structures between mild and moderate-to-severe depression suggested that the relationship between depression and HRQOL dimensions might be bidirectional.ConclusionThe prevalence of depression remained high in Chinese patients with cancer, and depression may influence various symptoms and functions within the HRQOL network. Screening and early treatment of depression were warranted to improve the overall HRQOL of cancer patients, in addition to adequate treatment of pain and nausea/vomiting and improvement in physical function.</p

Relationship between awareness of/use of/attitudes toward PrEP and willingness to use PrEP.

<p>Abbreviations: PEP, post-exposure prophylaxis; PrEP, pre-exposure prophylaxis; CI, confidence interval; OR, odds ratio.</p

Multivariate analysis of risk factors for any HPV infection.

<p>Multivariate analysis of risk factors for any HPV infection.</p

Relationship between demographic characteristics and willingness to use oral PrEP.

<p>Note: A total of 349 participants provided responses for employment status and education.</p><p>Abbreviations: PrEP, pre-exposure prophylaxis; CI, confidence interval; OR, odds ratio; RMB, Renminbi.</p

Characteristics of 500 study participants and univariate analysis of association between variables and any anal HPV infection [n (%)].

<p>Characteristics of 500 study participants and univariate analysis of association between variables and any anal HPV infection [n (%)].</p