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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.
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页码:828 / 839
页数:12
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