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Imaging and Clinical Prognostic Features in Lobar Versus Deep Intracerebral Hemorrhage in an Unselected Swedish Population

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Názov: Imaging and Clinical Prognostic Features in Lobar Versus Deep Intracerebral Hemorrhage in an Unselected Swedish Population
Autori: Hillal, Amir, Apostolaki‐Hansson, Trine, Ramgren, Birgitta, Norrving, Bo, Hansen, Björn, Wassélius, Johan, Ullberg, Teresa
Prispievatelia: Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section V, Diagnostic Radiology, (Lund), Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion V, Diagnostisk radiologi, Lund, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section IV, Neurology, Lund, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion IV, Neurologi, Lund, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section II, Thoracic Surgery, Neurological injury in acute type A aortic dissection, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion II, Thoraxkirurgi, Neurologiska skador vid akut aortadissektion typ A, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section V, Diagnostic Radiology, (Lund), Stroke Imaging Research group, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion V, Diagnostisk radiologi, Lund, Stroke Imaging Research group, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section V, Diagnostic Radiology, (Lund), Neuroradiology, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion V, Diagnostisk radiologi, Lund, Neuroradiologi, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section IV, Neurology, Lund, Stroke policy and quality register research, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion IV, Neurologi, Lund, Stroke policy och kvalitetsregisterforskning, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section IV, Neurology, Lund, Clinical Stroke Research Group, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion IV, Neurologi, Lund, Klinisk strokeforskning, Originator
Zdroj: European Journal of Neurology Intracerebral hemorrhage on head CT- Neuroimaging and prognostic aspects. 32(8):1-10
Predmety: Medical and Health Sciences, Clinical Medicine, Neurology, Medicin och hälsovetenskap, Klinisk medicin, Neurologi, Radiology and Medical Imaging, Radiologi och bildbehandling
Popis: Background Hematoma location may influence hematoma volume and risk of expansion, the strongest prognostic predictors in patients with intracerebral hemorrhage (ICH). This study aims to determine differences in imaging and clinical factors affecting survival in patients with lobar vs. deep ICH. Method Patients with spontaneous supratentorial ICH residing in Skåne county registered in the Swedish Stroke Register 2016–2020 were included. Baseline non-contrast CT scans were evaluated for hematoma location and volume, subarachnoid or intraventricular extension, hydrocephalus, and midline shift. Multivariable Cox- and logistic regression analyses were used to determine imaging and clinical factors associated with increased 90-day mortality rate and functional dependency (mRS 3–5). Results Of 1398 patients, 666 (48%) had lobar, and 732 (52%) had deep ICH. Lobar ICH volumes were larger (median 27 vs. 13 mL, p < 0.001) compared to deep ICH. At 90 days, the unadjusted mortality rate (34% vs. 32%; p = 0.33) and functional dependency (mRS 3–5: 60.4% vs. 62.4%; p = 0.52) were non-significant between deep and lobar ICH patients. In multivariable analysis adjusted for confounders, hematoma volume (≥ 80 mL (HR = 5.90; 95% CI: 3.40–10.23), 30–79 mL (HR = 4.24; 95% CI: 2.81–6.42), and 10–29 mL (HR = 2.21; 95% CI: 1.49–3.27)), deep ICH location (HR = 1.78, 95% CI: 1.39–2.29), hydrocephalus (HR = 1.69, 95% CI: 1.21–2.37), pre-stroke dependency (HR = 1.51, 95% CI: 1.18–1.94), antiplatelets at onset (HR = 1.47, 95% CI: 1.14–1.90), and age (HR =1.03, 95% CI: 1.02–1.04) were significantly associated with an increased 90-day mortality rate. Conclusion Despite larger hematoma volumes and older age in lobar ICH patients, lobar hemorrhages were associated with a lower mortality rate compared to deep hemorrhages. Our findings highlight the need to consider lobar and deep ICH separately in therapeutic and prognostic studies.
Prístupová URL adresa: https://doi.org/10.1111/ene.70318
Databáza: SwePub
Popis
Abstrakt:Background Hematoma location may influence hematoma volume and risk of expansion, the strongest prognostic predictors in patients with intracerebral hemorrhage (ICH). This study aims to determine differences in imaging and clinical factors affecting survival in patients with lobar vs. deep ICH. Method Patients with spontaneous supratentorial ICH residing in Skåne county registered in the Swedish Stroke Register 2016–2020 were included. Baseline non-contrast CT scans were evaluated for hematoma location and volume, subarachnoid or intraventricular extension, hydrocephalus, and midline shift. Multivariable Cox- and logistic regression analyses were used to determine imaging and clinical factors associated with increased 90-day mortality rate and functional dependency (mRS 3–5). Results Of 1398 patients, 666 (48%) had lobar, and 732 (52%) had deep ICH. Lobar ICH volumes were larger (median 27 vs. 13 mL, p < 0.001) compared to deep ICH. At 90 days, the unadjusted mortality rate (34% vs. 32%; p = 0.33) and functional dependency (mRS 3–5: 60.4% vs. 62.4%; p = 0.52) were non-significant between deep and lobar ICH patients. In multivariable analysis adjusted for confounders, hematoma volume (≥ 80 mL (HR = 5.90; 95% CI: 3.40–10.23), 30–79 mL (HR = 4.24; 95% CI: 2.81–6.42), and 10–29 mL (HR = 2.21; 95% CI: 1.49–3.27)), deep ICH location (HR = 1.78, 95% CI: 1.39–2.29), hydrocephalus (HR = 1.69, 95% CI: 1.21–2.37), pre-stroke dependency (HR = 1.51, 95% CI: 1.18–1.94), antiplatelets at onset (HR = 1.47, 95% CI: 1.14–1.90), and age (HR =1.03, 95% CI: 1.02–1.04) were significantly associated with an increased 90-day mortality rate. Conclusion Despite larger hematoma volumes and older age in lobar ICH patients, lobar hemorrhages were associated with a lower mortality rate compared to deep hemorrhages. Our findings highlight the need to consider lobar and deep ICH separately in therapeutic and prognostic studies.
ISSN:13515101
14681331
DOI:10.1111/ene.70318