Clinical course and outcomes of small supratentorial intracerebral hematomas
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.1/13095 |
Resumo: | Background and Purpose: Intracerebral hemorrhage (ICH) volume, particularly if >= 30 mL, is a major determinant of poor outcome. We used a multinational ICH data registry to study the characteristics, course, and outcomes of supratentorial hematomas with volumes <30 mL. Methods: Basic characteristics, clinical and radiological course, and 30-day outcomes of these patients were recorded. Outcomes were categorized as early neurological deterioration (END), hematoma expansion, Glasgow Outcome Scale (GOS), and in-hospital death. Poor outcome was defined as composite of in-hospital death and severe disability (GOS = 3). Comparison was conducted based on hemorrhage location. Logistic regression using dichotomized outcome scales was applied to determine predictors of poor outcome. Results: Among 375 cases of supratentorial ICH with volumes <30 mL, expansion and END rates were 19.2% and 7.5%, respectively. Hemorrhage growth was independently associated with END (odds ratio: 28.7, 95% confidence interval [CI]: 8.51-96.5; P < .0001). Expansion rates did not differ according to ICH location. Overall, 13.9% (exact binomial 95% CI: 10.5-17.8) died in the hospital and 29.1% (CI: 24.5-34.0) had severe disability at 30 days; there was a cumulative poor outcome rate of 42.9% (CI: 37.9-48.1). Age, admission Glasgow Coma Scale, intraventricular extension, and END were independently associated with poor outcome. There was no difference in poor outcome rates between lobar and deep locations (40.2% versus 43.8%, P = .56). Conclusion: Patients with supratentorial ICH <30 mL have high rates of poor outcome at 30 days, regardless of location. Nearly 1 in 5 hematomas <30 mL expands, leading to END or death. |
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Clinical course and outcomes of small supratentorial intracerebral hematomasHemorrhageMortalityVolumePredictorsGrowthStrokeScaleScoreBackground and Purpose: Intracerebral hemorrhage (ICH) volume, particularly if >= 30 mL, is a major determinant of poor outcome. We used a multinational ICH data registry to study the characteristics, course, and outcomes of supratentorial hematomas with volumes <30 mL. Methods: Basic characteristics, clinical and radiological course, and 30-day outcomes of these patients were recorded. Outcomes were categorized as early neurological deterioration (END), hematoma expansion, Glasgow Outcome Scale (GOS), and in-hospital death. Poor outcome was defined as composite of in-hospital death and severe disability (GOS = 3). Comparison was conducted based on hemorrhage location. Logistic regression using dichotomized outcome scales was applied to determine predictors of poor outcome. Results: Among 375 cases of supratentorial ICH with volumes <30 mL, expansion and END rates were 19.2% and 7.5%, respectively. Hemorrhage growth was independently associated with END (odds ratio: 28.7, 95% confidence interval [CI]: 8.51-96.5; P < .0001). Expansion rates did not differ according to ICH location. Overall, 13.9% (exact binomial 95% CI: 10.5-17.8) died in the hospital and 29.1% (CI: 24.5-34.0) had severe disability at 30 days; there was a cumulative poor outcome rate of 42.9% (CI: 37.9-48.1). Age, admission Glasgow Coma Scale, intraventricular extension, and END were independently associated with poor outcome. There was no difference in poor outcome rates between lobar and deep locations (40.2% versus 43.8%, P = .56). Conclusion: Patients with supratentorial ICH <30 mL have high rates of poor outcome at 30 days, regardless of location. Nearly 1 in 5 hematomas <30 mL expands, leading to END or death.ElsevierSapientiaBehrouz, RezaMisra, VivekGodoy, Daniel A.Topel, Christopher H.Masotti, LucaKlijn, Catharina J. M.Smith, Craig J.Parry-Jones, Adrian R.Slevin, Mark A.Silver, BrianWilley, Joshua Z.Masjuan Vallejo, JaimeNzwalo, HipólitoPopa-Wagner, AurelMalek, Ali R.Hafeez, ShaheryarDi Napoli, Mario2019-11-20T15:07:33Z2017-062017-06-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.1/13095eng1052-305710.1016/j.jstrokecerebrovasdis.2017.01.010info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-07-24T10:25:08Zoai:sapientia.ualg.pt:10400.1/13095Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:04:18.321247Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Clinical course and outcomes of small supratentorial intracerebral hematomas |
title |
Clinical course and outcomes of small supratentorial intracerebral hematomas |
spellingShingle |
Clinical course and outcomes of small supratentorial intracerebral hematomas Behrouz, Reza Hemorrhage Mortality Volume Predictors Growth Stroke Scale Score |
title_short |
Clinical course and outcomes of small supratentorial intracerebral hematomas |
title_full |
Clinical course and outcomes of small supratentorial intracerebral hematomas |
title_fullStr |
Clinical course and outcomes of small supratentorial intracerebral hematomas |
title_full_unstemmed |
Clinical course and outcomes of small supratentorial intracerebral hematomas |
title_sort |
Clinical course and outcomes of small supratentorial intracerebral hematomas |
author |
Behrouz, Reza |
author_facet |
Behrouz, Reza Misra, Vivek Godoy, Daniel A. Topel, Christopher H. Masotti, Luca Klijn, Catharina J. M. Smith, Craig J. Parry-Jones, Adrian R. Slevin, Mark A. Silver, Brian Willey, Joshua Z. Masjuan Vallejo, Jaime Nzwalo, Hipólito Popa-Wagner, Aurel Malek, Ali R. Hafeez, Shaheryar Di Napoli, Mario |
author_role |
author |
author2 |
Misra, Vivek Godoy, Daniel A. Topel, Christopher H. Masotti, Luca Klijn, Catharina J. M. Smith, Craig J. Parry-Jones, Adrian R. Slevin, Mark A. Silver, Brian Willey, Joshua Z. Masjuan Vallejo, Jaime Nzwalo, Hipólito Popa-Wagner, Aurel Malek, Ali R. Hafeez, Shaheryar Di Napoli, Mario |
author2_role |
author author author author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Sapientia |
dc.contributor.author.fl_str_mv |
Behrouz, Reza Misra, Vivek Godoy, Daniel A. Topel, Christopher H. Masotti, Luca Klijn, Catharina J. M. Smith, Craig J. Parry-Jones, Adrian R. Slevin, Mark A. Silver, Brian Willey, Joshua Z. Masjuan Vallejo, Jaime Nzwalo, Hipólito Popa-Wagner, Aurel Malek, Ali R. Hafeez, Shaheryar Di Napoli, Mario |
dc.subject.por.fl_str_mv |
Hemorrhage Mortality Volume Predictors Growth Stroke Scale Score |
topic |
Hemorrhage Mortality Volume Predictors Growth Stroke Scale Score |
description |
Background and Purpose: Intracerebral hemorrhage (ICH) volume, particularly if >= 30 mL, is a major determinant of poor outcome. We used a multinational ICH data registry to study the characteristics, course, and outcomes of supratentorial hematomas with volumes <30 mL. Methods: Basic characteristics, clinical and radiological course, and 30-day outcomes of these patients were recorded. Outcomes were categorized as early neurological deterioration (END), hematoma expansion, Glasgow Outcome Scale (GOS), and in-hospital death. Poor outcome was defined as composite of in-hospital death and severe disability (GOS = 3). Comparison was conducted based on hemorrhage location. Logistic regression using dichotomized outcome scales was applied to determine predictors of poor outcome. Results: Among 375 cases of supratentorial ICH with volumes <30 mL, expansion and END rates were 19.2% and 7.5%, respectively. Hemorrhage growth was independently associated with END (odds ratio: 28.7, 95% confidence interval [CI]: 8.51-96.5; P < .0001). Expansion rates did not differ according to ICH location. Overall, 13.9% (exact binomial 95% CI: 10.5-17.8) died in the hospital and 29.1% (CI: 24.5-34.0) had severe disability at 30 days; there was a cumulative poor outcome rate of 42.9% (CI: 37.9-48.1). Age, admission Glasgow Coma Scale, intraventricular extension, and END were independently associated with poor outcome. There was no difference in poor outcome rates between lobar and deep locations (40.2% versus 43.8%, P = .56). Conclusion: Patients with supratentorial ICH <30 mL have high rates of poor outcome at 30 days, regardless of location. Nearly 1 in 5 hematomas <30 mL expands, leading to END or death. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-06 2017-06-01T00:00:00Z 2019-11-20T15:07:33Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.1/13095 |
url |
http://hdl.handle.net/10400.1/13095 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
1052-3057 10.1016/j.jstrokecerebrovasdis.2017.01.010 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Elsevier |
publisher.none.fl_str_mv |
Elsevier |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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