Predisposing factors, management, and prognostic evaluation of acute carotid blowout syndrome

Hsueh Ju Lu, Kuo Wei Chen, Ming Huang Chen, Pen Yuan Chu, Shyh Kuan Tai, Ling Wei Wang, Peter Mu Hsin Chang*, Muh Hwa Yang

*此作品的通信作者

研究成果: Article同行評審

42 引文 斯高帕斯(Scopus)

摘要

Background: Massive hemorrhages occur in 6%-10% of patients with advanced cancer. Acute carotid blowout syndrome is the most severe massive hemorrhagic complication in head and neck cancer patients. Methods: This was a single institute, retrospective, case control study. A total of 45 patients were enrolled in this study. The predisposing factors, management, and prognosis of acute carotid blowout syndrome were evaluated. Results: Among the baseline characteristics, the site of the primary tumor (P =.003), origin of bleeding (P =.048), method of intervention (P =.005), and time to intervention (P =.006) were significantly different factors between survivor and nonsurvivor patients. After 24 hours of onset, a Glasgow Coma Scale score (P =.000), the use of inotropic agents (P =.007), and neutrophil-to-lymphocyte ratio (P =.019) were significantly predicting factors for outcome. Multivariate logistic regression analyses revealed bleeding from common carotid artery was an independent factor for long-term survival (odds ratio, 25.951; 95% confidence interval [CI], 1.373-490.441; P <.030). The median overall survival of survivors and nonsurvivors were 12.1 (range, 3.7-118.7; 95% CI, 4.33-54.87) and 11.9 (range, 0.7-53.5; 95% CI, 5.78-25.69) months, respectively (P =.092). Conclusions: Early and aggressive intervention is important for the successful management of acute carotid blowout syndrome. The Glasgow Coma Scale score, the use of inotropic agents, and neutrophil-to-lymphocyte ratio 24 hours after the onset were predictive factors for patients' outcomes. Bleeding from common carotid artery is an independent prognostic factor in multivariate analysis. Long-term survival can be achieved after successful management.

原文English
頁(從 - 到)1226-1235
頁數10
期刊Journal of Vascular Surgery
58
發行號5
DOIs
出版狀態Published - 11月 2013

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