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Practice patterns for neurosurgical utilization and outcome in acute intracerebral hemorrhage: intensive blood pressure reduction in acute cerebral hemorrhage trials 1 and 2 studies

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dc.contributor.author Guo, Rui
dc.contributor.author Blacker, David J.
dc.contributor.author Wang, Xia
dc.contributor.author Arima, Hisatomi
dc.contributor.author Lavados, Pablo
dc.contributor.author Lindley, Richard
dc.contributor.author Chalmers, John
dc.contributor.author Anderson, Craig
dc.contributor.author Robinson, Thompson
dc.contributor.author INTERACT Investigators
dc.date.accessioned 2017-09-12T12:15:27Z
dc.date.available 2017-09-12T12:15:27Z
dc.date.issued 2017
dc.identifier.citation Neurosurgery. 2017 Jun 10 es_CL
dc.identifier.uri http://hdl.handle.net/11447/1672
dc.description.abstract BACKGROUND: The prognosis in acute spontaneous intracerebral hemorrhage (ICH) is related to hematoma volume, where >30 mL is commonly used to define large ICH as a threshold for neurosurgical decompression but without clear supporting evidence. OBJECTIVES: To determine the factors associated with large ICH and neurosurgical intervention among participants of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trials (INTERACT). METHODS: We performed pooled analysis of the pilot INTERACT1 (n = 404) and main INTERACT2 (n = 2839) studies of ICH patients (<6 h of onset) with elevated systolic blood pressure (SBP, 150-220 mm Hg) who were randomized to intensive (target SBP < 140 mm Hg) or contemporaneous guideline-recommended (target SBP < 180 mm Hg) management. Neurosurgical intervention data were collected at 7 d postrandomization. Multivariable logistic regression was used to determine associations. RESULTS: There were 372 (13%) patients with large ICH volume (>30 mL), which was associated with nonresiding in China, nondiabetic status, severe neurological deficit (National Institutes of Health stroke scale [NIHSS] score ≥ 15), lobar location, intraventricular hemorrhage extension, raised leucocyte count, and hyponatremia. Significant predictors of those patients who underwent surgery (226 of 3233 patients overall; 83 of 372 patients with large ICH) were younger age, severe neurological deficit (lower Glasgow coma scale score, and NIHSS score ≥ 15), baseline ICH volume > 30 mL, and intraventricular hemorrhage. CONCLUSIONS: Early identification of severe ICH, based on age and clinical and imaging parameters, may facilitate neurosurgery and intensive monitoring of patients es_CL
dc.format.extent 1 es_CL
dc.language.iso en_US es_CL
dc.publisher Oxford University Press es_CL
dc.subject Clinical trial es_CL
dc.subject INTERACT es_CL
dc.subject Intracerebral hemorrhage es_CL
dc.subject Neurosurgery es_CL
dc.subject Prognosis es_CL
dc.title Practice patterns for neurosurgical utilization and outcome in acute intracerebral hemorrhage: intensive blood pressure reduction in acute cerebral hemorrhage trials 1 and 2 studies es_CL
dc.type Artículo es_CL


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