Association of baseline hematoma and edema volumes with one-year outcome and long-term survival after spontaneous intracerebral hemorrhage: A community-based inception cohort study

被引:13
作者
Loan, James J. M. [1 ,2 ,3 ]
Gane, Angus B. [2 ]
Middleton, Laura [4 ]
Sargent, Brendan [5 ]
Moullaali, Tom James [1 ]
Rodrigues, Mark A. [1 ,4 ]
Cunningham, Laura [5 ]
Wardlaw, Joanna [1 ,3 ]
Salman, Rustam Al-Shahi [1 ,2 ]
Samarasekera, Neshika [1 ,2 ]
机构
[1] Univ Edinburgh, Ctr Clin Brain Sci, Chancellors Bldg 49, Edinburgh EH16 4SB, Midlothian, Scotland
[2] NHS Lothian, Dept Clin Neurosci, Edinburgh, Midlothian, Scotland
[3] Univ Edinburgh, UK Dementia Res Inst Edinburgh, Edinburgh, Midlothian, Scotland
[4] Dept Neuroradiol NHS Lothian, Edinburgh, Midlothian, Scotland
[5] Univ Edinburgh, Edinburgh Med Sch, Edinburgh, Midlothian, Scotland
基金
英国医学研究理事会; 英国惠康基金;
关键词
Cohort study; intracerebral hemorrhage; outcome; peri-hematomal edema; radiology; survival; PERIHEMATOMAL EDEMA; PERIHEMORRHAGIC EDEMA; PERIHAEMATOMAL EDEMA; EXTENSION DISTANCE; PREDICTORS; DETERIORATION; MORTALITY; LOCATION; GROWTH;
D O I
10.1177/1747493020974282
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background Hospital-based studies have reported variable associations between outcome after spontaneous intracerebral hemorrhage and peri-hematomal edema volume. Aims In a community-based study, we aimed to investigate the existence, strength, direction, and independence of associations between intracerebral hemorrhage and peri-hematomal edema volumes on diagnostic brain CT and one-year functional outcome and long-term survival. Methods We identified all adults, resident in Lothian, diagnosed with first-ever, symptomatic spontaneous intracerebral hemorrhage between June 2010 and May 2013 in a community-based, prospective inception cohort study. We defined regions of interest manually and used a semi-automated approach to measure intracerebral hemorrhage volume, peri-hematomal edema volume, and the sum of these measurements (total lesion volume) on first diagnostic brain CT performed at <= 3 days after symptom onset. The primary outcome was death or dependence (scores 3-6 on the modified Rankin Scale) at one-year after intracerebral hemorrhage. Results Two hundred ninety-two (85%) of 342 patients (median age 77.5 y, IQR 68-83, 186 (54%) female, median time from onset to CT 6.5 h (IQR 2.9-21.7)) were dead or dependent one year after intracerebral hemorrhage. Peri-hematomal edema and intracerebral hemorrhage volumes were colinear (R-2 = 0.77). In models using both intracerebral hemorrhage and peri-hematomal edema, 10 mL increments in intracerebral hemorrhage (adjusted odds ratio (aOR) 1.72 (95% CI 1.08-2.87); p = 0.029) but not peri-hematomal edema volume (aOR 0.92 (0.63-1.45); p = 0.69) were independently associated with one-year death or dependence. 10 mL increments in total lesion volume were independently associated with one-year death or dependence (aOR 1.24 (1.11-1.42); p = 0.0004). Conclusion Total volume of intracerebral hemorrhage and peri-hematomal edema, and intracerebral hemorrhage volume alone on diagnostic brain CT, undertaken at three days or sooner, are independently associated with death or dependence one-year after intracerebral hemorrhage, but peri-hematomal edema volume is not. Data access statement Anonymized summary data may be requested from the corresponding author.
引用
收藏
页码:828 / 839
页数:12
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