Absolute risk and predictors of the growth of acute spontaneous intracerebral haemorrhage: a systematic review and meta-analysis of individual patient data

Autor: Al-Shahi Salman, Rustam, Frantzias, Joseph, Lee, Robert J., Lyden, Patrick D., Battey, Thomas W. K., Ayres, Alison M., Goldstein, Joshua N., Mayer, Stephan A., Steiner, Thorsten, Wang, Xia, Arima, Hisatomi, Hasegawa, Hitoshi, Oishi, Makoto, Godoy, Daniel A., Masotti, Luca, Dowlatshahi, Dar, Rodriguez-Luna, David, Molina, Carlos A., Jang, Dong-Kyu, Dávalos, Antoni, Castillo, José, Yao, Xiaoying, Claassen, Jan, Volbers, Bastian, Kazui, Seiji, Okada, Yasushi, Fujimoto, Shigeru, Toyoda, Kazunori, Li, Qi, Khoury, Jane, Delgado Martínez, María Pilar, Álvarez Sabín, José, Hernández-Guillamon, Mar, Prats-Sánchez, Luis Antonio, Cai, Chunyan, Kate, Mahesh P., McCourt, Rebecca, Venkatasubramanian, Chitra, Diringer, Michael N., Ikeda, Yukio, Worthmann, Hans, Ziai, Wendy C., d'Esterre, Christopher D., Aviv, Richard I, Raab, Peter, Murai, Yasuo, Zazulia, Allyson R., Butcher, Kenneth S., Seyedsaadat, Seyed Mohammad, Grotta, James C., Martí-Fàbregas, Joan, Montaner, Joan, Broderick, Joseph P, Yamamoto, Haruko, Staykov, Dimitre, Connolly, E. Sander, Selim, Magdy, Leira, Rogelio, Moon, Byung Hoo, Demchuk, Andrew, Di Napoli, Mario, Fujii, Yukihiko, Anderson, Craig S.., Rosand, Jonathan, Universitat Autònoma de Barcelona
Přispěvatelé: VISTA-ICH Collaboration, ICH Growth Individual Patient Data Meta-analysis Collaborators
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Dipòsit Digital de Documents de la UAB
Universitat Autònoma de Barcelona
Al-Shahi Salman, R.; Frantzias, J.; Lee, R. J.; Lyden, P. D.; Battey, T. W. K.; Ayres, A. M.; Goldstein, J. N.; Mayer, S. A.; Steiner, T.; Wang, X.; Arima, H.; Hasegawa, H.; Oishi, M.; Godoy, D. A.; Masotti, L.; Dowlatshahi, D.; Rodriguez-Luna, D.; Molina, C. A.; Jang, D. K.; Davalos, A.; ... (2018). Absolute risk and predictors of the growth of acute spontaneous intracerebral haemorrhage: a systematic review and meta-analysis of individual patient data. Lancet neurology, 17(10), pp. 885-894. Elsevier 10.1016/s1474-4422(18)30253-9
The Lancet. Neurology
LANCET NEUROLOGY
r-IGTP. Repositorio Institucional de Producción Científica del Instituto de Investigación Germans Trias i Pujol
instname
ISSN: 1474-4422
DOI: 10.7892/boris.124646
Popis: Altres ajuts: UK Medical Research Council and British Heart Foundation. Intracerebral haemorrhage growth is associated with poor clinical outcome and is a therapeutic target for improving outcome. We aimed to determine the absolute risk and predictors of intracerebral haemorrhage growth, develop and validate prediction models, and evaluate the added value of CT angiography. In a systematic review of OVID MEDLINE-with additional hand-searching of relevant studies' bibliographies- from Jan 1, 1970, to Dec 31, 2015, we identified observational cohorts and randomised trials with repeat scanning protocols that included at least ten patients with acute intracerebral haemorrhage. We sought individual patient-level data from corresponding authors for patients aged 18 years or older with data available from brain imaging initially done 0·5-24 h and repeated fewer than 6 days after symptom onset, who had baseline intracerebral haemorrhage volume of less than 150 mL, and did not undergo acute treatment that might reduce intracerebral haemorrhage volume. We estimated the absolute risk and predictors of the primary outcome of intracerebral haemorrhage growth (defined as >6 mL increase in intracerebral haemorrhage volume on repeat imaging) using multivariable logistic regression models in development and validation cohorts in four subgroups of patients, using a hierarchical approach: patients not taking anticoagulant therapy at intracerebral haemorrhage onset (who constituted the largest subgroup), patients taking anticoagulant therapy at intracerebral haemorrhage onset, patients from cohorts that included at least some patients taking anticoagulant therapy at intracerebral haemorrhage onset, and patients for whom both information about anticoagulant therapy at intracerebral haemorrhage onset and spot sign on acute CT angiography were known. Of 4191 studies identified, 77 were eligible for inclusion. Overall, 36 (47%) cohorts provided data on 5435 eligible patients. 5076 of these patients were not taking anticoagulant therapy at symptom onset (median age 67 years, IQR 56-76), of whom 1009 (20%) had intracerebral haemorrhage growth. Multivariable models of patients with data on antiplatelet therapy use, data on anticoagulant therapy use, and assessment of CT angiography spot sign at symptom onset showed that time from symptom onset to baseline imaging (odds ratio 0·50, 95% CI 0·36-0·70; p
Databáze: OpenAIRE
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