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Clinical course and outcomes of small supratentorial intracerebral hematomas

2017-06Journal article Open access
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dc.contributor.authorBehrouz, Reza
dc.contributor.authorMisra, Vivek
dc.contributor.authorGodoy, Daniel A.
dc.contributor.authorTopel, Christopher H.
dc.contributor.authorMasotti, Luca
dc.contributor.authorKlijn, Catharina J. M.
dc.contributor.authorSmith, Craig J.
dc.contributor.authorParry-Jones, Adrian R.
dc.contributor.authorSlevin, Mark A.
dc.contributor.authorSilver, Brian
dc.contributor.authorWilley, Joshua Z.
dc.contributor.authorMasjuan Vallejo, Jaime
dc.contributor.authorNzwalo, HipĂłlito
dc.contributor.authorPopa-Wagner, Aurel
dc.contributor.authorMalek, Ali R.
dc.contributor.authorHafeez, Shaheryar
dc.contributor.authorDi Napoli, Mario
dc.date.accessioned2019-11-20T15:07:33Z
dc.date.available2019-11-20T15:07:33Z
dc.date.issued2017-06
dc.description.abstractBackground 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.
dc.identifier.doi10.1016/j.jstrokecerebrovasdis.2017.01.010
dc.identifier.issn1052-3057
dc.identifier.urihttp://hdl.handle.net/10400.1/13095
dc.language.isoeng
dc.peerreviewedyes
dc.publisherElsevier
dc.subjectHemorrhage
dc.subjectMortality
dc.subjectVolume
dc.subjectPredictors
dc.subjectGrowth
dc.subjectStroke
dc.subjectScale
dc.subjectScore
dc.titleClinical course and outcomes of small supratentorial intracerebral hematomas
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1221
oaire.citation.issue6
oaire.citation.startPage1216
oaire.citation.titleJournal of Stroke & Cerebrovascular Diseases
oaire.citation.volume26
person.familyNameNzwalo
person.givenNameHipĂłlito
person.identifier337064
person.identifier.ciencia-id2C1F-E4F3-2C79
person.identifier.orcid0000-0002-1502-3534
person.identifier.ridAAG-3931-2020
person.identifier.scopus-author-id36057285600
rcaap.rightsopenAccess
rcaap.typearticle
relation.isAuthorOfPublication287f7d4e-5ad8-4794-b526-c61d32c00446
relation.isAuthorOfPublication.latestForDiscovery287f7d4e-5ad8-4794-b526-c61d32c00446

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