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The speed of ultraearly hematoma growth in acute intracerebral hemorrhage

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dc.contributor.author Sato, Shoichiro
dc.contributor.author Arima, Hisatomi
dc.contributor.author Hirakawa, Yoichiro
dc.contributor.author Heeley, Emma
dc.contributor.author Delcourt, Candice
dc.contributor.author Beer, Ronny
dc.contributor.author Li, Yuechun
dc.contributor.author Zhang, Jingfen
dc.contributor.author Jüettler, Eric
dc.contributor.author Wang, Jiguang
dc.contributor.author Lavados, Pablo
dc.contributor.author Robinson, Thompson
dc.contributor.author Lindley, Richard
dc.contributor.author Chalmers, John
dc.contributor.author Anderson, Craig
dc.date.accessioned 2017-03-14T19:59:10Z
dc.date.available 2017-03-14T19:59:10Z
dc.date.issued 2014
dc.identifier.citation Neurology. 2014 Dec 9; 83(24): 2232–2238.
dc.identifier.uri http://hdl.handle.net/11447/1029
dc.identifier.uri http://dx.doi.org/10.1212/WNL.0000000000001076
dc.description.abstract Objective: The prognostic importance of the speed of early hematoma growth in acute intracerebral hemorrhage (ICH) has not been well established. We aimed to determine the association between the rate of increase in hematoma volume and major clinical outcomes in the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT) studies. The effects of early intensive blood pressure (BP) lowering according to the speed of hematoma growth were also investigated. Methods: Pooled analyses of the INTERACT1 (n = 404) and INTERACT2 (n = 2,839) studies—randomized controlled trials of patients with spontaneous ICH with elevated systolic BP, randomly assigned to intensive (target systolic BP <140 mm Hg) or guideline-based (<180 mm Hg) BP management. The speed of ultraearly hematoma growth (UHG) was defined as hematoma volume (mL)/onset-to-CT time (hours). Primary outcome was death or major disability (modified Rankin Scale score of 3–6) at 90 days. Results: Among a total of 2,909 patients (90%) with information on UHG and outcome, median speed of UHG was 6.2 mL/h. There was a linear association between UHG and outcome: multivariable-adjusted odd ratios 1.90 (95% confidence interval 1.50–2.39) for 5–10 mL/h and 2.96 (2.36–3.71) for >10 mL/h vs the <5 mL/h group. There were no clear differences in the effects of intensive BP lowering according to 3 speeds of UHG on outcome (p = 0.75 for homogeneity). Conclusions: The speed of UHG in patients with ICH was continuously associated with increased risks of death or major disability, and from lower levels than previously reported (≥5 mL/h). The benefits of intensive BP lowering appear to be independent of the speed of bleeding.
dc.format.extent 7
dc.language.iso en_US
dc.publisher American Academy of Neurology
dc.subject Blood Pressure/physiology
dc.subject Cerebral Hemorrhage/physiopathology
dc.subject Hematoma/pathology
dc.subject Prognosis
dc.title The speed of ultraearly hematoma growth in acute intracerebral hemorrhage
dc.type Artículo


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