Determinants and Prognostic Significance of Hematoma Sedimentation Levels in Acute Intracerebral Hemorrhage
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Determinants and Prognostic Significance of Hematoma Sedimentation Levels in Acute Intracerebral Hemorrhage. / Sato, Shoichiro; Delcourt, Candice; Zhang, Shihong; Arima, Hisatomi; Heeley, Emma; Zheng, Danni; Al-Shahi Salman, Rustam; Stapf, Christian; Tzourio, Christophe; Robinson, Thompson; Lindley, Richard I; Chalmers, John; Anderson, Craig S; INTERACT2 investigators.
In: CEREBROVASC DIS, Vol. 41, No. 1-2, 2016, p. 80-6.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Determinants and Prognostic Significance of Hematoma Sedimentation Levels in Acute Intracerebral Hemorrhage
AU - Sato, Shoichiro
AU - Delcourt, Candice
AU - Zhang, Shihong
AU - Arima, Hisatomi
AU - Heeley, Emma
AU - Zheng, Danni
AU - Al-Shahi Salman, Rustam
AU - Stapf, Christian
AU - Tzourio, Christophe
AU - Robinson, Thompson
AU - Lindley, Richard I
AU - Chalmers, John
AU - Anderson, Craig S
AU - INTERACT2 investigators
AU - Thomalla, Götz
N1 - © 2015 S. Karger AG, Basel.
PY - 2016
Y1 - 2016
N2 - BACKGROUND: This study aimed at identifying the determinants and prognostic significance of a sedimentation level (fluid-blood level) in the hematoma among patients with acute intracerebral hemorrhage (ICH) who participated in the main Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2).METHODS: Post-hoc analysis of the INTERACT2 dataset, a randomized controlled trial of patients with acute ICH with elevated systolic blood pressure (SBP), randomly assigned to intensive (target SBP <140 mm Hg) or guideline-based (<180 mm Hg) BP management. Patients with a sedimentation level at baseline assessment on CT, and modified Rankin Scale score at 90-day, were included in these analyses. Factors associated with a sedimentation level and its significance in relation to 90-day clinical outcomes were assessed in univariable and multivariable logistic regression models.RESULTS: Of 2,065 participants, 19 (1%) had sedimentation level on baseline CT, which was independently associated with warfarin use (p = 0.006) and lobar ICH (p = 0.025). Sedimentation level was also associated with death or major disability at 90-day in both crude (84 vs. 53%; p = 0.014) and multivariable analyses adjusted for age, gender, Chinese region, warfarin use, baseline National Institutes of Health Stroke Scale score, onset to CT time, volume and location of ICH, intraventricular extension, and randomized intensive BP lowering (OR 3.94, 95% CI 1.01-15.37; p = 0.049).CONCLUSIONS: The presence of hematoma sedimentation level on baseline CT is associated with warfarin use and lobar location of ICH, and predicts a worse outcome. Although uncommon, sedimentation level is an easily detectable prognostic factor in acute ICH.
AB - BACKGROUND: This study aimed at identifying the determinants and prognostic significance of a sedimentation level (fluid-blood level) in the hematoma among patients with acute intracerebral hemorrhage (ICH) who participated in the main Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2).METHODS: Post-hoc analysis of the INTERACT2 dataset, a randomized controlled trial of patients with acute ICH with elevated systolic blood pressure (SBP), randomly assigned to intensive (target SBP <140 mm Hg) or guideline-based (<180 mm Hg) BP management. Patients with a sedimentation level at baseline assessment on CT, and modified Rankin Scale score at 90-day, were included in these analyses. Factors associated with a sedimentation level and its significance in relation to 90-day clinical outcomes were assessed in univariable and multivariable logistic regression models.RESULTS: Of 2,065 participants, 19 (1%) had sedimentation level on baseline CT, which was independently associated with warfarin use (p = 0.006) and lobar ICH (p = 0.025). Sedimentation level was also associated with death or major disability at 90-day in both crude (84 vs. 53%; p = 0.014) and multivariable analyses adjusted for age, gender, Chinese region, warfarin use, baseline National Institutes of Health Stroke Scale score, onset to CT time, volume and location of ICH, intraventricular extension, and randomized intensive BP lowering (OR 3.94, 95% CI 1.01-15.37; p = 0.049).CONCLUSIONS: The presence of hematoma sedimentation level on baseline CT is associated with warfarin use and lobar location of ICH, and predicts a worse outcome. Although uncommon, sedimentation level is an easily detectable prognostic factor in acute ICH.
KW - Aged
KW - Aged, 80 and over
KW - Anticoagulants
KW - Antihypertensive Agents
KW - Cerebral Hemorrhage
KW - Disease Management
KW - Female
KW - Hematoma
KW - Humans
KW - Hypertension
KW - Logistic Models
KW - Male
KW - Middle Aged
KW - Multivariate Analysis
KW - Prognosis
KW - Risk Factors
KW - Tomography, X-Ray Computed
KW - Warfarin
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
U2 - 10.1159/000442532
DO - 10.1159/000442532
M3 - SCORING: Journal article
C2 - 26671408
VL - 41
SP - 80
EP - 86
JO - CEREBROVASC DIS
JF - CEREBROVASC DIS
SN - 1015-9770
IS - 1-2
ER -