Prognostic significance of delayed intraventricular haemorrhage in the INTERACT studies.
J Neurol Neurosurg Psychiatry
; 88(1): 19-24, 2017 Jan.
Article
em En
| MEDLINE
| ID: mdl-26746184
ABSTRACT
BACKGROUND AND PURPOSE:
Intraventricular extension of intracerebral haemorrhage (ICH) predicts poor outcome, but the significance of delayed intraventricular haemorrhage (dIVH) is less well defined. We determined the prognostic significance of dIVH in the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trials (INTERACT 1 and 2).METHODS:
Pooled analyses of the INTERACT CT substudies-international, multicentre, prospective, open, blinded end point, randomised controlled trials of patients with acute spontaneous ICH and elevated systolic blood pressure (SBP)-randomly assigned to intensive (<140â mmâ Hg) or guideline-based (<180â mmâ Hg) SBP management. Participants had blinded central analyses of baseline and 24â h CTs, with dIVH defined as new intraventricular haemorrhage (IVH) on the latter scan. Outcomes of death and major disability were defined by modified Rankin Scale scores at 90â days.RESULTS:
There were 349 (27%) of 1310 patients with baseline IVH, and 107 (11%) of 961 initially IVH-free patients who developed dIVH. Significant associations of dIVH were prior warfarin anticoagulation, high (≥15) baseline National Institutes of Health Stroke Scale score, larger (≥15â mL) ICH volume, greater ICH growth and higher achieved SBP over 24â h. Compared with those who were IVH-free, dIVH had greater odds of 90-day death or major disability versus initial IVH (adjusted ORs 2.84 (95% CI 1.52 to 5.28) and 1.87 (1.36 to 2.56), respectively (p trend <0.0001)).CONCLUSIONS:
Although linked to factors determining greater ICH growth including poor SBP control, dIVH is independently associated with poor outcome in acute small to moderate-size ICH. TRIAL REGISTRATION NUMBERS NCT00226096 and NCT00716079.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hemorragia Cerebral
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Ventrículos Cerebrais
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Hemorragia
Tipo de estudo:
Clinical_trials
/
Prognostic_studies
Limite:
Aged
/
Female
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Humans
/
Male
Idioma:
En
Revista:
J Neurol Neurosurg Psychiatry
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Austrália