Abstract:
BACKGROUND AND PURPOSE:Perihematomal edema (PHE) is associated with poor outcomes after intracerebral hemorrhage (ICH). PHE evolves in the early period after ICH, providing a therapeutic target and window for intervention. We studied the effect of PHE volume expansion in the first 72 hours (iPHE) and its relationship with functional outcomes. METHODS:We used data contained in the Virtual International Stroke Trials Archive. We included patients who presented within 6 hours of symptom onset, had baseline clinical, radiological, and laboratory data, and further computed tomographic scan data at 72 hours and 90-day functional outcomes. We calculated iPHE and used logistic regression analysis to assess relationships with outcome. We adjusted for confounding variables and the primary outcome measure poor day-90 outcome (defined as modified Rankin Scale score of ≥3. We performed subgroup analyses by location and by volume of ICH. RESULTS:We included 596 patients with ICH. Median baseline hematoma volume was 15.0 mL (IQR, 7.9-29.2) and median baseline PHE volume was 8.7 mL (IQR, 4.5-15.5). Hematoma expansion occurred in 122 (34.9%) patients. Median iPHE was 14.7 mL (IQR, 6.6-30.3). The odds of a poor outcome were greater with increasing iPHE (OR, 1.78; CI, 1.12-2.64 per mL increase). Subgroup analyses showed that iPHE was only related to poor functional outcomes in basal ganglia and small (<30 mL) ICH. CONCLUSIONS:Absolute increase in PHE during 72 hours was associated with worse functional outcomes after ICH, particularly with basal ganglia ICH and hematomas <30 mL.
journal_name
Strokejournal_title
Strokeauthors
Murthy SB,Moradiya Y,Dawson J,Lees KR,Hanley DF,Ziai WC,VISTA-ICH Collaborators.doi
10.1161/STROKEAHA.115.010054subject
Has Abstractpub_date
2015-11-01 00:00:00pages
3088-92issue
11eissn
0039-2499issn
1524-4628pii
STROKEAHA.115.010054journal_volume
46pub_type
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