Association of baseline hematoma and edema volumes with one-year outcome and long-term survival after spontaneous intracerebral hemorrhage: A community-based inception cohort study



Loan, James JM ORCID: 0000-0002-6451-9448, Gane, Angus B, Middleton, Laura, Sargent, Brendan ORCID: 0000-0003-2262-7755, Moullaali, Tom James ORCID: 0000-0002-6786-3623, Rodrigues, Mark A ORCID: 0000-0002-4507-6872, Cunningham, Laura, Wardlaw, Joanna ORCID: 0000-0002-9812-6642, Salman, Rustam Al-Shahi, Samarasekera, Neshika
et al (show 156 more authors) (2021) Association of baseline hematoma and edema volumes with one-year outcome and long-term survival after spontaneous intracerebral hemorrhage: A community-based inception cohort study. International Journal of Stroke, 16 (7). 828 - 839.

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Abstract

<jats:sec><jats:title>Background</jats:title><jats:p> Hospital-based studies have reported variable associations between outcome after spontaneous intracerebral hemorrhage and peri-hematomal edema volume. </jats:p></jats:sec><jats:sec><jats:title>Aims</jats:title><jats:p> In a community-based study, we aimed to investigate the existence, strength, direction, and independence of associations between intracerebral hemorrhage and peri-hematomal edema volumes on diagnostic brain CT and one-year functional outcome and long-term survival. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> We identified all adults, resident in Lothian, diagnosed with first-ever, symptomatic spontaneous intracerebral hemorrhage between June 2010 and May 2013 in a community-based, prospective inception cohort study. We defined regions of interest manually and used a semi-automated approach to measure intracerebral hemorrhage volume, peri-hematomal edema volume, and the sum of these measurements (total lesion volume) on first diagnostic brain CT performed at ≤3 days after symptom onset. The primary outcome was death or dependence (scores 3–6 on the modified Rankin Scale) at one-year after intracerebral hemorrhage. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Two hundred ninety-two (85%) of 342 patients (median age 77.5 y, IQR 68–83, 186 (54%) female, median time from onset to CT 6.5 h (IQR 2.9–21.7)) were dead or dependent one year after intracerebral hemorrhage. Peri-hematomal edema and intracerebral hemorrhage volumes were colinear ( R<jats:sup>2</jats:sup> = 0.77). In models using both intracerebral hemorrhage and peri-hematomal edema, 10 mL increments in intracerebral hemorrhage (adjusted odds ratio (aOR) 1.72 (95% CI 1.08–2.87); p = 0.029) but not peri-hematomal edema volume (aOR 0.92 (0.63–1.45); p = 0.69) were independently associated with one-year death or dependence. 10 mL increments in total lesion volume were independently associated with one-year death or dependence (aOR 1.24 (1.11–1.42); p = 0.0004). </jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p> Total volume of intracerebral hemorrhage and peri-hematomal edema, and intracerebral hemorrhage volume alone on diagnostic brain CT, undertaken at three days or sooner, are independently associated with death or dependence one-year after intracerebral hemorrhage, but peri-hematomal edema volume is not. </jats:p></jats:sec><jats:sec><jats:title>Data access statement</jats:title><jats:p> Anonymized summary data may be requested from the corresponding author. </jats:p></jats:sec>

Item Type: Article
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Clinical Directorate
Depositing User: Symplectic Admin
Date Deposited: 04 Aug 2022 15:28
Last Modified: 18 Aug 2022 16:10
DOI: 10.1177/1747493020974282
Open Access URL: https://journals.sagepub.com/doi/pdf/10.1177/17474...
URI: https://livrepository.liverpool.ac.uk/id/eprint/3160359