Hematoma growth is a determinant of mortality and poor outcome after intracerebral hemorrhage
| Autor: | S M, Davis, J, Broderick, M, Hennerici, N C, Brun, M N, Diringer, S A, Mayer, K, Begtrup, T, Steiner |
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| Rok vydání: | 2006 |
| Předmět: |
Male
Poison control Factor VIIa Hematoma Risk Factors medicine Humans cardiovascular diseases Aged Cerebral Hemorrhage Intracerebral hemorrhage Vascular disease business.industry Hazard ratio Glasgow Coma Scale Factor VII medicine.disease Prognosis Recombinant Proteins Blood pressure Intraventricular hemorrhage Hematoma Subdural Anesthesia Female Neurology (clinical) business Tomography X-Ray Computed |
| Zdroj: | Neurology. 66(8) |
| ISSN: | 1526-632X |
| Popis: | Although volume of intracerebral hemorrhage (ICH) is a predictor of mortality, it is unknown whether subsequent hematoma growth further increases the risk of death or poor functional outcome.To determine if hematoma growth independently predicts poor outcome, the authors performed an individual meta-analysis of patients with spontaneous ICH who had CT within 3 hours of onset and 24-hour follow-up. Placebo patients were pooled from three trials investigating dosing, safety, and efficacy of rFVIIa (n = 115), and 103 patients from the Cincinnati study (total 218). Other baseline factors included age, gender, blood glucose, blood pressure, Glasgow Coma Score (GCS), intraventricular hemorrhage (IVH), and location.Overall, 72.9% of patients exhibited some degree of hematoma growth. Percentage hematoma growth (hazard ratio [HR] 1.05 per 10% increase [95% CI: 1.03, 1.08; p0.0001]), initial ICH volume (HR 1.01 per mL [95% CI: 1.00, 1.02; p = 0.003]), GCS (HR 0.88 [95% CI: 0.81, 0.96; p = 0.003]), and IVH (HR 2.23 [95% CI: 1.25, 3.98; p = 0.007]) were all associated with increased mortality. Percentage growth (cumulative OR 0.84 [95% CI: 0.75, 0.92; p0.0001]), initial ICH volume (cumulative OR 0.94 [95% CI: 0.91, 0.97; p0.0001]), GCS (cumulative OR 1.46 [95% CI: 1.21, 1.82; p0.0001]), and age (cumulative OR 0.95 [95% CI: 0.92, 0.98; p = 0.0009]) predicted outcome modified Rankin Scale. Gender, location, blood glucose, and blood pressure did not predict outcomes.Hematoma growth is an independent determinant of both mortality and functional outcome after intracerebral hemorrhage. Attenuation of growth is an important therapeutic strategy. |
| Databáze: | OpenAIRE |
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