Significance of Hematoma Shape and Density in Intracerebral Hemorrhage: The Intensive Blood Pressure Reduction in Acute Intracerebral Hemorrhage Trial Study

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dc.contributor.authorDelcourt, Candice
dc.contributor.authorZhang, Shihong
dc.contributor.authorArima, Hisatomi
dc.contributor.authorSato, Shoichiro
dc.contributor.authorSalman, Rustam
dc.contributor.authorWang, Xia
dc.contributor.authorDavies, Leo
dc.contributor.authorStapf, Christian
dc.contributor.authorThompson, Robinson
dc.contributor.authorLavados, Pablo
dc.contributor.authorChalmers, John
dc.contributor.authorHeeley, Emma
dc.contributor.authorliu, Ming
dc.contributor.authorLindley, Richard
dc.contributor.authorAnderson, Craig
dc.contributor.authorINTERACT2 investigators
dc.date.accessioned2017-01-04T19:29:02Z
dc.date.available2017-01-04T19:29:02Z
dc.date.issued2016
dc.description.abstractBACKGROUND AND PURPOSE: In patients with acute intracerebral hemorrhage (ICH), the shape and density of the hematoma are associated with its subsequent growth, but the impact of these parameters on clinical outcome is uncertain. METHODS: Baseline computed tomographic scans and clinical data were obtained in the Intensive Blood Pressure Reduction in Acute Intracerebral Hemorrhage Trial (INTERACT2). Three independent neurologists blind to clinical data assessed ICH for shape and density using a previously described scale. Shape was defined as irregular when the ICH had ≥2 extra lesions added to the ellipsoid-shaped ICH. Density was heterogeneous when there were ≥3 low-density lesions within the ICH. Outcome measures were death and major disability (modified Rankin scale score of 3-5), combined and separate at 90-day postrandomization. Multivariable logistic regression models were used to determine the significance of hematoma characteristics on outcome. RESULTS: There were 2066 patient computed tomographic scans included in the analysis, with 46% and 38% having irregular and heterogeneous ICH, respectively. Irregular shape was independently associated with death/major disability (adjusted odds ratio, 1.60; 95% confidence interval [CI], 1.29-1.98) and major disability alone (adjusted odds ratio, 1.60; 95% CI, 1.31-1.95), but not with death alone (adjusted odds ratio, 0.97; 95% CI, 0.68-1.39). Heterogeneous density was not associated with clinical outcomes (adjusted odds ratio, 1.06; 95% CI, 0.85-1.33), 1.04 (95% CI, 0.73-1.48), and 1.14 (95% CI, 0.93-1.39), respectively, for death/major disability, death alone, and disability alone). CONCLUSIONS: Irregular shape, but not heterogeneous density, is independently associated with poor outcome after ICH. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00716079.
dc.identifier.citationDelcourt C, Zhang S, Arima H, Sato S, Al-Shahi Salman R, Wang X, Davies L, Stapf C, Robinson T, Lavados PM, Chalmers J, Heeley E, Liu M, Lindley RI, Anderson CS; INTERACT2 investigators. Significance of Hematoma Shape and Density in Intracerebral Hemorrhage: The Intensive Blood Pressure Reduction in Acute Intracerebral Hemorrhage Trial Study. Stroke. 2016 May;47(5):1227-32.
dc.identifier.urihttp://hdl.handle.net/11447/930
dc.identifier.urihttp://dx.doi.org/ 10.1161/STROKEAHA.116.012921
dc.language.isoen_US
dc.publisherAmerican Heart Association, Inc.
dc.subjectBlood pressure
dc.subjectBrain imaging
dc.subjectCerebral hemorrhage
dc.subjectHypertension
dc.subjectStroke
dc.titleSignificance of Hematoma Shape and Density in Intracerebral Hemorrhage: The Intensive Blood Pressure Reduction in Acute Intracerebral Hemorrhage Trial Study
dc.typeArtículo

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