|Hematoma growth and outcomes in intracerebral hemorrhage The INTERACT1 study|
|Delcourt, Candice1; Huang, Yining2; Arima, Hisatomi1; Chalmers, John1; Davis, Stephen M.3; Heeley, Emma L.1; Wang, Jiguang4; Parsons, Mark W.5; Liu, Guorong; Anderson, Craig S.1; INTERACT1 Investigators|
|WOS标题词||Science & Technology|
|研究领域[WOS]||Neurosciences & Neurology|
|关键词[WOS]||ACTIVATED FACTOR-VII ; BLOOD-PRESSURE REDUCTION ; ENLARGEMENT ; MORTALITY ; TRIAL|
Objective: Uncertainty exists over the size of potential beneficial effects of medical treatments targeting hematoma growth in intracerebral hemorrhage (ICH). We report associations of hematoma growth parameters on clinical outcomes in the pilot phase, Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT1) (ClinicalTrials.gov NCT00226096).
Methods: In randomized patients with both baseline and 24-hour brain CT (n = 335), associations between measures of absolute and relative hematoma growth and 90-day poor outcomes of death and dependency (modified Rankin Scale score 3-5) were assessed in logistic regression models, with data reported as odds ratios (OR) and 95% confidence intervals (CI).
Results: A total of 10.7 mL (1 SD) increase in hematoma volume over 24 hours was strongly associated with poor outcome (adjusted OR 1.72, 95% CI 1.19-2.49; p = 0.004). An association was also evident for relative growth (adjusted OR 1.67,95% 1.22-2.27; p = 0.001 for 1 SD increase). The analyses were adjusted for age, sex, achieved systolic blood pressure, elevated NIH Stroke Scale score (>= 14), hematoma location, baseline hematoma volume, intraventricular extension, antithrombotic therapy, baseline glucose, time from ICH to baseline CT scan, and time from baseline to repeat CT scan. A 1 mL increase in hematoma growth was associated with a 5% (95% CI 2%-9%) higher risk of death or dependency.
Conclusion: Medical treatments, such as rapid intensive blood pressure lowering, could achieve similar to 2-4 mL absolute attenuation of hematoma growth. There is hope that this could translate into modest but still clinically worthwhile (similar to 10%-20% better chance) outcome from ICH. Neurology (R) 2012; 79:314-319
|资助机构||National Health and Medical Research Council of Australia ; Australian Research Council ; Servier ; National Health and Medical Research Council of Australia|
|作者单位||1.Univ Sydney, Royal Prince Alfred Hosp, George Inst Global Hlth, Sydney, NSW 2006, Australia|
2.Peking Univ, Hosp 1, Dept Neurol, Beijing, Peoples R China
3.Univ Melbourne, Royal Melbourne Hosp, Dept Neurol, Melbourne, Vic 3010, Australia
4.Shanghai Res Inst Hypertens, Shanghai, Peoples R China
5.John Hunter Hosp, Hunter Med Res Inst, Dept Neurol, Newcastle, NSW, Australia
6.Baotou Cent Hosp, Dept Neurol, Baotou, Peoples R China
|Delcourt, Candice,Huang, Yining,Arima, Hisatomi,et al. Hematoma growth and outcomes in intracerebral hemorrhage The INTERACT1 study[J]. NEUROLOGY,2012,79(4):314-319.|
|APA||Delcourt, Candice.,Huang, Yining.,Arima, Hisatomi.,Chalmers, John.,Davis, Stephen M..,...&INTERACT1 Investigators.(2012).Hematoma growth and outcomes in intracerebral hemorrhage The INTERACT1 study.NEUROLOGY,79(4),314-319.|
|MLA||Delcourt, Candice,et al."Hematoma growth and outcomes in intracerebral hemorrhage The INTERACT1 study".NEUROLOGY 79.4(2012):314-319.|