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学科主题: 临床医学
题名:
Significance of Intraventricular Hemorrhage in Acute Intracerebral Hemorrhage Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial Results
作者: Chan, Edward1,2; Anderson, Craig S.1,2; Wang, Xia1,2; Arima, Hisatomi1,2; Saxena, Anubhav1,2; Moullaali, Tom J.1; Heeley, Emma1,2; Delcourt, Candice1,2; Wu, Guojun3; Wang, Jinchao3; Chen, Guofang4; Lavados, Pablo M.5,6; Stapf, Christian7,8; Robinson, Thompson9,10; Chalmers, John1,2; Huang, Yining11; INTERACT2 Investigators
关键词: cerebral hemorrhage ; cerebral ventricles ; clinical trial ; mortality ; outcome measures
刊名: STROKE
发表日期: 2015-03-01
DOI: 10.1161/STROKEAHA.114.008470
卷: 46, 期:3, 页:653-658
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Clinical Neurology ; Peripheral Vascular Disease
研究领域[WOS]: Neurosciences & Neurology ; Cardiovascular System & Cardiology
关键词[WOS]: VENTRICULAR BLOOD ; DETERIORATION ; PREDICTORS ; STROKE
英文摘要:

Background and Purpose-Intraventricular hemorrhage (IVH) with spontaneous intracerebral hemorrhage indicates a poor prognosis but uncertainty exists over the pattern of association. We aimed to elucidate risk associations of IVH and outcome in the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2) data set.

Methods-INTERACT2 was an international prospective, open-blinded end point, randomized controlled trial in 2839 patients with intracerebral hemorrhage (<6 hours) with elevated systolic blood pressure randomly assigned to intensive (target systolic blood pressure <140 mm Hg) or guideline-based (systolic blood pressure <180 mm Hg) blood pressure management. Associations of baseline IVH in 740 of 2613 (28%) patients and poor outcomes (death and major disability defined on the modified Rankin Scale) at 90 days were determined in linear and logistic regression models.

Results-Patients with IVH were significantly older and with greater neurological impairment, history of ischemic stroke, and larger hematomas more often deep hemisphere located at presentation, after adjustment for other baseline variables. Death or major disability occurred in 66% with IVH versus 49% in intracerebral hemorrhage-alone patients (adjusted odds ratio, 1.68; 95% confidence interval, 1.38-2.06; P<0.01). Associations of IVH volume and clinical outcomes were strong and near continuous. Adjusted analyses by thirds of IVH volume indicate thresholds of approximate to 5 and 10 mL for significantly increased odds of death and death or major disability, respectively.

Conclusions-A strong association exists between the amount of IVH and poor outcome in intracerebral hemorrhage. An IVH volume of 5 to 10 mL emerges as a significant threshold for decision making on prognosis in these patients.

语种: 英语
WOS记录号: WOS:000350284900021
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/55029
Appears in Collections:北京大学第一临床医学院_神经内科_期刊论文

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作者单位: 1.Univ Chile, Dept Neurol Sci, Santiago, Chile
2.Hop Lariboisiere, AP HP, Dept Neurol, F-75475 Paris, France
3.Univ Sydney, Cent Clin Sch, Sydney, NSW 2006, Australia
4.Hebei Yutian Hosp, Dept Neurol, Tangshan, Peoples R China
5.Royal Prince Alfred Hosp, George Inst Global Hlth, Neurol & Mental Hlth Div, Sydney, NSW, Australia
6.Xuzhou Cent Hosp, Dept Neurol, Xuzhou, Jiangsu, Peoples R China
7.Univ Desarrollo, Clin Alemana, Dept Med, Serv Neurol, Santiago, Chile
8.Univ Paris Diderot, DHU NeuroVasc Paris Sorbonne, Sorbonne Paris Cite, Paris, France
9.Univ Leicester, Dept Cardiovasc Sci, Leicester, Leics, England
10.Univ Leicester, NIHR Biomed Res Unit Cardiovasc Dis, Leicester, Leics, England
11.Peking Univ, Hosp 1, Dept Neurol, Beijing 100871, Peoples R China

Recommended Citation:
Chan, Edward,Anderson, Craig S.,Wang, Xia,et al. Significance of Intraventricular Hemorrhage in Acute Intracerebral Hemorrhage Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial Results[J]. STROKE,2015,46(3):653-658.
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