Factors related to intracerebral haematoma in patients with aneurysmal subarachnoid haemorrhage in Vietnam: a multicentre prospective cohort study.

Autor:	Nguyen TA; Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam.; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam., Mai TD; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam.; Stroke Center, Bach Mai Hospital, Hanoi, Viet Nam.; Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam., Vu LD; Department of Radiology, Hanoi Medical University, Hanoi, Viet Nam.; Radiology Centre, Bach Mai Hospital, Hanoi, Viet Nam., Dao CX; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam.; Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam.; Center for Critical Care Medicine, Bach Mai Hospital, Hanoi, Viet Nam., Ngo HM; Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam.; Department of Neurosurgery II, Neurosurgery Center, Vietnam-Germany Friendship Hospital, Hanoi, Viet Nam.; Department of Surgery, Hanoi Medical University, Hanoi, Viet Nam., Hoang HB; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam.; Emergency and Critical Care Department, Hanoi Medical University Hospital, Hanoi Medical University, Hanoi, Viet Nam., Tran TA; Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam.; Department of Radiology, Hanoi Medical University, Hanoi, Viet Nam.; Radiology Centre, Bach Mai Hospital, Hanoi, Viet Nam., Pham TQ; Department of Surgery, Hanoi Medical University, Hanoi, Viet Nam.; Department of Neurosurgery, Bach Mai Hospital, Hanoi, Viet Nam., Pham DT; Department of Nutrition and Food Safety, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam., Nguyen MH; Department of Health Organization and Management, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam., Nguyen LQ; Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam.; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam., Dao PV; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam.; Stroke Center, Bach Mai Hospital, Hanoi, Viet Nam.; Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam., Nguyen DN; Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam., Vuong HTT; Department of Emergency, Vietnam-Czechoslovakia Friendship Hospital, Hai Phong, Viet Nam., Vu HD; Emergency and Critical Care Department, Hanoi Medical University Hospital, Hanoi Medical University, Hanoi, Viet Nam., Nguyen DD; Department of Neurosurgery II, Neurosurgery Center, Vietnam-Germany Friendship Hospital, Hanoi, Viet Nam., Vu TD; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam.; Department of Emergency, Agriculture General Hospital, Hanoi, Viet Nam., Nguyen DT; Stroke Center, Bach Mai Hospital, Hanoi, Viet Nam., Do ALN; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam., Pham QT; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam., Khuat NH; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam.; Department of Intensive Care and Poison Control, Duc Giang General Hospital, Hanoi, Viet Nam., Duong NV; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam.; Department of Intensive Care and Poison Control, Dien Bien Provincial General Hospital, Dien Bien Phu, Viet Nam., Ngo CC; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam.; Department of Emergency, Military Central Hospital 108, Hanoi, Viet Nam., Do SN; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam.; Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam.; Center for Critical Care Medicine, Bach Mai Hospital, Hanoi, Viet Nam., Nguyen HT; Department of Surgery, Hanoi Medical University, Hanoi, Viet Nam.; Department of Neurosurgery, Bach Mai Hospital, Hanoi, Viet Nam., Nguyen CV; Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam.; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam., Nguyen AD; Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam.; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam., Luong CQ; Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam luongquocchinh@gmail.com.; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam.; Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2023 Apr 21; Vol. 13 (4), pp. e066186. Date of Electronic Publication: 2023 Apr 21.
DOI:	10.1136/bmjopen-2022-066186
Abstrakt:	Objectives: To investigate the impact of intracerebral haematoma (ICH) on the outcomes and the factors related to an ICH in patients with aneurysmal subarachnoid haemorrhage (aSAH) in a low- and middle-income country. Design: A multicentre prospective cohort study. Setting: Three central hospitals in Hanoi, Vietnam. Participants: This study included all patients (≥18 years) presenting with aSAH to the three central hospitals within 4 days of ictus, from August 2019 to June 2021, and excluded patients for whom the admission Glasgow Coma Scale was unable to be scored or patients who became lost at 90 days of follow-up during the study. Outcome Measures: The primary outcome was ICH after aneurysm rupture, defined as ICH detected on an admission head CT scan. The secondary outcomes were 90-day poor outcomes and 90-day death. Results: Of 415 patients, 217 (52.3%) were females, and the median age was 57.0 years (IQR: 48.0-67.0). ICH was present in 20.5% (85/415) of patients with aSAH. There was a significant difference in the 90-day poor outcomes (43.5% (37/85) and 29.1% (96/330); p=0.011) and 90-day mortality (36.5% (31/85) and 20.0% (66/330); p=0.001) between patients who had ICH and patients who did not have ICH. The multivariable regression analysis showed that systolic blood pressure (SBP) ≥140 mm Hg (adjusted odds ratio (AOR): 2.674; 95% CI: 1.372 to 5.214; p=0.004), World Federation of Neurosurgical Societies (WFNS) grades II (AOR: 3.683; 95% CI: 1.250 to 10.858; p=0.018) to V (AOR: 6.912; 95% CI: 2.553 to 18.709; p<0.001) and a ruptured middle cerebral artery (MCA) aneurysm (AOR: 3.717; 95% CI: 1.848 to 7.477; p<0.001) were independently associated with ICH on admission. Conclusions: In this study, ICH was present in a substantial proportion of patients with aSAH and contributed significantly to a high rate of poor outcomes and death. Higher SBP, worse WFNS grades and ruptured MCA aneurysms were independently associated with ICH on admission. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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