Chronic Kidney Disease in Patients with Acute Intracerebral Hemorrhage: Association with Large Hematoma Volume and Poor Outcome

Autor: Oleg Merzeliak, Noa Molshatzki, David Tanne, Rakefet Tsabari, Yvonne Schwammenthal, David Orion, Maya Toashi
Rok vydání: 2010
Předmět:
Male
medicine.medical_specialty
Time Factors
Renal function
Kaplan-Meier Estimate
Kidney
urologic and male genital diseases
Risk Assessment
Severity of Illness Index
Hematoma
Risk Factors
Internal medicine
Severity of illness
Odds Ratio
medicine
Humans
Longitudinal Studies
Prospective Studies
Registries
Israel
Prospective cohort study
Intensive care medicine
Aged
Cerebral Hemorrhage
Proportional Hazards Models
Aged
80 and over
Intracerebral hemorrhage
Chi-Square Distribution
business.industry
Odds ratio
Middle Aged
Prognosis
medicine.disease
female genital diseases and pregnancy complications
Logistic Models
Neurology
Chronic Disease
Female
Kidney Diseases
Neurology (clinical)
Tomography
X-Ray Computed
Cardiology and Cardiovascular Medicine
Risk assessment
business
Glomerular Filtration Rate
Kidney disease
Zdroj: Cerebrovascular Diseases. 31:271-277
ISSN: 1421-9786
1015-9770
Popis: Background: Chronic kidney disease (CKD) is associated with both a risk of adverse vascular outcome and a risk of bleeding. We have tested the hypothesis that in the setting of an acute intracerebral hemorrhage (ICH), CKD is associated with poor outcome and with larger hematoma volume. Methods: We examined the association between CKD and ICH characteristics and outcome within a prospective cohort study of consecutive patients hospitalized with an acute stroke and followed for 1 year. CKD was categorized by the estimated baseline glomerular filtration rate into moderate/severe impairment (60 ml/min/1.73 m2). Results: Among 128 patients with an ICH (mean age = 71.7 ± 12.3 years, 41.4% women) 46.1% had CKD (23.4% mild and 22.7% moderate/severe). Patients with moderate/severe impairment had >4-fold adjusted hazard ratio for mortality over 1 year (4.29; 95% CI = 1.69–10.90) compared to patients with no impairment. The hematoma volumes [median (25–75%)] were 15.3 ml (5.4–37.5) in patients with no impairment, 16.6 (6.8–36.9) in mild impairment and 50.2 (10.4–109.1) in moderate/severe impairment (p = 0.009). The location of the hematoma was lobar in 12% with no impairment, 17% with mild impairment and 39% with moderate/severe impairment (p = 0.02). Patients with moderate/severe impairment exhibited a 2.3-fold higher hematoma volume (p = 0.04) and a >6-fold higher odds of lobar location (95% CI = 1.59–24.02) as compared to no impairment. Further adjustment for antiplatelet use and for presence of leukoaraiosis attenuated the association with hematoma volume (p = 0.15), while moderate/severe impairment was associated with an adjusted OR of 5.35 (95% CI = 1.18–24.14) for lobar location. Conclusions: Presence of moderate/severe CKD among patients with ICH is associated with larger, lobar hematomas and with poor outcome.
Databáze: OpenAIRE
Externí odkaz: