Longer term stroke risk in intracerebral haemorrhage survivors



Banerjee, Gargi, Wilson, Duncan, Ambler, Gareth, Hostettler, Isabel Charlotte, Shakeshaft, Clare, Cohen, Hannah, Yousry, Tarek, Salman, Rustam Al-Shahi, Lip, Gregory YH ORCID: 0000-0002-7566-1626, Houlden, Henry
et al (show 5 more authors) (2020) Longer term stroke risk in intracerebral haemorrhage survivors. Journal of Neurology, Neurosurgery and Psychiatry, 91 (8). pp. 840-845.

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Abstract

<h4>Objective</h4>To evaluate the influence of intracerebral haemorrhage (ICH) location on stroke outcomes.<h4>Methods</h4>We included patients recruited to a UK hospital-based, multicentre observational study of adults with imaging confirmed spontaneous ICH. The outcomes of interest were occurrence of a cerebral ischaemic event (either stroke or transient ischaemic attack) or a further ICH following study entry. Haematoma location was classified as lobar or non-lobar.<h4>Results</h4>All 1094 patients recruited to the CROMIS-2 (Clinical Relevance of Microbleeds in Stroke) ICH study were included (mean age 73.3 years; 57.4% male). There were 45 recurrent ICH events (absolute event rate (AER) 1.88 per 100 patient-years); 35 in patients presenting with lobar ICH (n=447, AER 3.77 per 100 patient-years); and 9 in patients presenting with non-lobar ICH (n=580, AER 0.69 per 100 patient-years). Multivariable Cox regression found that lobar ICH was associated with ICH recurrence (HR 8.96, 95% CI 3.36 to 23.87, p<0.0001); similar results were found in multivariable completing risk analyses. There were 70 cerebral ischaemic events (AER 2.93 per 100 patient-years); 29 in patients presenting with lobar ICH (AER 3.12 per 100 patient-years); and 39 in patients with non-lobar ICH (AER 2.97 per 100 patient-years). Multivariable Cox regression found no association with ICH location (HR 1.13, 95% CI 0.66 to 1.92, p <b><i>=</i></b> 0.659). Similar results were seen in completing risk analyses.<h4>Conclusions</h4>In ICH survivors, lobar ICH location was associated with a higher risk of recurrent ICH events than non-lobar ICH; ICH location did not influence risk of subsequent ischaemic events.<h4>Trial registration number</h4>NCT02513316.

Item Type: Article
Uncontrolled Keywords: CROMIS-2 collaborators, Brain, Humans, Recurrence, Tomography, X-Ray Computed, Treatment Outcome, Proportional Hazards Models, Risk Factors, Aged, Survivors, Female, Male, Neuroimaging, Hemorrhagic Stroke
Depositing User: Symplectic Admin
Date Deposited: 30 Sep 2020 07:45
Last Modified: 18 Jan 2023 23:30
DOI: 10.1136/jnnp-2020-323079
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3103080