Hematoma growth is a determinant of mortality and poor outcome after intracerebral hemorrhage

• Verfasst von: Davis, Stephen [VerfasserIn]
• Verfasst von: Broderick, J. [VerfasserIn]
• Verfasst von: Hennerici, Michael G. [VerfasserIn]
• Verfasst von: Brun, N. C. [VerfasserIn]
• Verfasst von: Diringer, M. N. [VerfasserIn]
• Verfasst von: Mayer, S. A. [VerfasserIn]
• Verfasst von: Begtrup, K. [VerfasserIn]
• Verfasst von: Steiner, T. [VerfasserIn]
• Titel: Hematoma growth is a determinant of mortality and poor outcome after intracerebral hemorrhage
• Verf.angabe: S.M. Davis, J. Broderick, M. Hennerici, N.C. Brun, M.N. Diringer, S.A. Mayer, K. Begtrup, and T. Steiner, for the Recombinant Activated Factor VII Intracerebral Hemorrhage Trial Investigators
• E-Jahr: 2006
• Jahr: April 24, 2006
• Umfang: 7 S.
• Fussnoten: Gesehen am 09.05.2022
• Titel Quelle: Enthalten in: Neurology
• Ort Quelle: Philadelphia, Pa. : Wolters Kluwer, 1951
• Jahr Quelle: 2006
• Band/Heft Quelle: 66(2006), 8, Seite 1175-1181
• ISSN Quelle: 1526-632X
• DOI: doi:10.1212/01.wnl.0000208408.98482.99
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Aged
• Sach-SW: Cerebral Hemorrhage
• Sach-SW: Factor VII
• Sach-SW: Factor VIIa
• Sach-SW: Female
• Sach-SW: Hematoma, Subdural
• Sach-SW: Humans
• Sach-SW: Male
• Sach-SW: Prognosis
• Sach-SW: Recombinant Proteins
• Sach-SW: Risk Factors
• Sach-SW: Tomography, X-Ray Computed
• K10plus-PPN: 1801195072

Abstract

BACKGROUND: 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. - METHODS: 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. - RESULTS: 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; p < 0.0001]), 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; p < 0.0001]), initial ICH volume (cumulative OR 0.94 [95% CI: 0.91, 0.97; p < 0.0001]), GCS (cumulative OR 1.46 [95% CI: 1.21, 1.82; p < 0.0001]), 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. - CONCLUSIONS: Hematoma growth is an independent determinant of both mortality and functional outcome after intracerebral hemorrhage. Attenuation of growth is an important therapeutic strategy.