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学科主题: 临床医学
题名:
Significance of perihematomal edema in acute intracerebral hemorrhage The INTERACT trial
作者: Arima, H.1,2; Wang, J. G.3; Huang, Y.4; Heeley, E.1,2; Skulina, C.1,2; Parsons, M. W.5,6; Peng, B.7; Li, Q.1,2; Su, S.8; Tao, Q. L.1; Li, Y. C.9,14; Jiang, J. D.10; Tai, L. W.11; Zhang, J. L.12; Xu, E.13; Cheng, Y.1; Morgenstern, L. B.15; Chalmers, J.1,2; Anderson, C. S.1; INTERACT Investigators1
刊名: NEUROLOGY
发表日期: 2009-12-08
DOI: 10.1212/WNL.0b013e3181c55ed3
卷: 73, 期:23, 页:1963-1968
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Clinical Neurology
研究领域[WOS]: Neurosciences & Neurology
关键词[WOS]: CEREBRAL-HEMORRHAGE ; STROKE ; VOLUME ; ASSOCIATION ; PREDICTOR ; MORTALITY
英文摘要:

Background: Uncertainty surrounds the effects of cerebral edema on outcomes in intracerebral hemorrhage (ICH).

Methods: We used data from the INTERACT trial to determine the predictors and prognostic significance of "perihematomal" edema over 72 hours after ICH. INTERACT included 404 patients with CT-confirmed ICH and elevated systolic blood pressure (BP) (150-220 mm Hg) who had the capacity to commence BP lowering treatment within 6 hours of ICH. Baseline and repeat CT (24 and 72 hours) were performed using standardized techniques, with digital images analyzed centrally. Predictors of growth in edema were determined using generalized estimating equations, and its effects on clinical outcomes were estimated using a logistic regression model.

Results: Overall, 270 patients had 3 sequential CT scans available for analyses. At baseline, there was a highly significant correlation between hematoma and perihematomal edema volumes (r(2) = 0.45). Lower systolic BP and baseline hematoma volume were independently associated with absolute increase in perihematomal edema volume. History of hypertension, baseline hematoma volume, and earlier time from onset to CT were independently associated with relative increase in edema volume. Both absolute and relative increases in perihematomal edema growth were significantly associated with death or dependency at 90 days after adjustment for age, gender, and randomized treatment, but not when additionally adjusted for baseline hematoma volume.

Conclusions: The degree of, and growth in, perihematomal edema are strongly related to the size of the underlying hematoma of acute intracerebral hemorrhage, and do not appear to have a major independent effect in determining the outcome from this condition. Neurology (R) 2009; 73: 1963-1968

语种: 英语
所属项目编号: 358395 ; R01 NS38916 ; R01 NS62675
项目资助者: National Health and Medical Research Council of Australia ; Health Research Council of New Zealand ; Ministry of Education, Culture, Sports, Science, and Technology of Japan ; University of Sydney ; Japan Heart Foundation ; OMRON Corporation ; Pfizer Inc. ; National Natural Science Foundation of China ; Shanghai Commissions of Science and Technology ; Shanghai Commission of Education ; European Union ; NIH ; Les Laboratoires Servier ; National Health and Medical Research Council of Australia ; Boehringer Ingelheim ; Genzyme Corporation
WOS记录号: WOS:000272466800008
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/50851
Appears in Collections:北京大学第一临床医学院_期刊论文

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作者单位: 1.Baotou Cent Hosp, Baotou, Peoples R China
2.First Hosp Nanjing, Nanjing, Peoples R China
3.Hebei Med Univ, Hosp 2, Shijiazhuang, Peoples R China
4.Chinese PLA 263 Hosp, Beijing, Peoples R China
5.Univ Sydney, Sydney, NSW 2006, Australia
6.Peking Univ, Hosp 1, Beijing 100871, Peoples R China
7.Univ Newcastle, John Hunter Hosp, New Lambton, Australia
8.Univ Newcastle, Hunter Med Res Inst, New Lambton, Australia
9.Tianjin Med Univ, Gen Hosp, Tianjin, Peoples R China
10.Univ Michigan, Sch Med, Ann Arbor, MI USA
11.Royal Prince Alfred Hosp, George Inst Int Hlth, Sydney, NSW 2050, Australia
12.Shanghai Jiao Tong Univ, Rui Jin Hosp, Shanghai Inst Hypertens, Shanghai 200030, Peoples R China
13.Beijing Union Med Coll Hosp, Beijing, Peoples R China
14.Univ Western Australia, Sch Math & Stat, Perth, WA 6009, Australia
15.Guangzhou Med Coll, Affiliated Hosp 2, Guangzhou, Guangdong, Peoples R China

Recommended Citation:
Arima, H.,Wang, J. G.,Huang, Y.,et al. Significance of perihematomal edema in acute intracerebral hemorrhage The INTERACT trial[J]. NEUROLOGY,2009,73(23):1963-1968.
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