The "SALPARE study" of spontaneous intracerebral hemorrhage: part 1.

Autor: De Rosa L; Stroke Unit and Neurosonology Laboratory, Padua University Hospital, Padua, Italy. ludovica.derosa@studenti.unipd.it., Manara R; Neuroradiology Unit, Padua University Hospital, Padua, Italy., Vodret F; Stroke Unit and Neurosonology Laboratory, Padua University Hospital, Padua, Italy., Kulyk C; Stroke Unit and Neurosonology Laboratory, Department of Neurology, Johannes Kepler University Linz, Linz, Austria., Montano F; Neuroradiology, Department of Medicine and Surgery, University of Salerno, Salerno, Italy., Pieroni A; Stroke Unit and Neurosonology Laboratory, Padua University Hospital, Padua, Italy., Viaro F; Stroke Unit and Neurosonology Laboratory, Padua University Hospital, Padua, Italy., Zedde ML; Neurology Unit, Stroke Unit, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy., Napoletano R; UOC Neurologia AOU S. Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy., Ermani M; Service of Medical Statistics, Department of Neurology, Padua University Hospital, Padua, Italy., Baracchini C; Stroke Unit and Neurosonology Laboratory, Padua University Hospital, Padua, Italy.
Jazyk: angličtina
Zdroj: Neurological research and practice [Neurol Res Pract] 2023 Feb 02; Vol. 5 (1), pp. 5. Date of Electronic Publication: 2023 Feb 02.
DOI: 10.1186/s42466-023-00231-1
Abstrakt: Background: Spontaneous intracerebral hemorrhage (ICH) is a devastating type of stroke with a huge impact on patients and families. Expanded use of oral anticoagulants and ageing population might contribute to an epidemiological change. In view of these trends, we planned a study to obtain a contemporary picture and identify early prognostic factors to improve secondary prevention.
Methods: This multicenter prospective cohort study included consecutive adult patients with non-traumatic ICH admitted to three academic Italian hospitals (Salerno, Padova, Reggio Emilia) over a 2-year period. Demographic characteristics, vascular risk profile, clinical data and main radiological characteristics were correlated to 90-day clinical outcome.
Results: Out of 682 patients [mean age: 73 ± 14 years; 316 (46.3%) females] enrolled in this study, 40% died [86/180 (47.8%) in Salerno, 120/320 (37.5%) in Padova, 67/182 (36.8%) in Reggio Emilia; p < 0.05)] and 36% were severely disabled at 90 days. Several factors were associated with a higher risk of poor functional outcome such as antithrombotic drug use, hyperglycemia, previous cerebrovascular accident, low platelet count, and pontine/massive/intraventricular hemorrhage. However, at multivariate analysis only pre-ICH mRS score (OR 30.84), GCS score at presentation (OR 11.88), initial hematoma volume (OR 29.71), and NIHSS score at presentation (OR 25.89) were independent predictors of death and poor functional outcome.
Conclusion: Despite the heterogeneity among centers, this study on ICH has identified four simple prognostic factors that can independently predict patients outcome, stratify their risk, and guide their management.
(© 2023. The Author(s).)
Databáze: MEDLINE
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