Mannitol and Outcome in Intracerebral Hemorrhage: Propensity Score and Multivariable Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial 2 Results

Simple item page
dc.contributor.authorWang, Xia
dc.contributor.authorArima, Hisatomi
dc.contributor.authorYang, Jie
dc.contributor.authorZhang, Shihong
dc.contributor.authorWu, Goujun
dc.contributor.authorWoodward, Mark
dc.contributor.authorMuñoz, Paula
dc.contributor.authorLavados, Pablo
dc.contributor.authorStapf, Christian
dc.contributor.authorThompson, Robinson
dc.contributor.authorHeeley, Emma
dc.contributor.authorDelcourt, Candice
dc.contributor.authorLindley, Richard
dc.contributor.authorParsons, Mark
dc.contributor.authorChalmers, John
dc.contributor.authorAnderson, Craig
dc.contributor.authorINTERACT2 Investigators
dc.date.accessioned2016-05-25T19:52:37Z
dc.date.available2016-05-25T19:52:37Z
dc.date.issued2015
dc.description.abstractBACKGROUND AND PURPOSE: Mannitol is often used to reduce cerebral edema in acute intracerebral hemorrhage but without strong supporting evidence of benefit. We aimed to determine the impact of mannitol on outcome among participants of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2). METHODS: INTERACT2 was an international, open, blinded end point, randomized controlled trial of 2839 patients with spontaneous intracerebral hemorrhage (<6 hours) and elevated systolic blood pressure allocated to intensive (target systolic blood pressure, <140 mm Hg within 1 hour) or guideline-recommended (target systolic blood pressure, <180 mm Hg) blood pressure-lowering treatment. Propensity score and multivariable analyses were performed to investigate the relationship between mannitol treatment (within 7 days) and poor outcome, defined by death or major disability on the modified Rankin Scale score (3-6) at 90 days. RESULTS: There was no significant difference in poor outcome between mannitol (n=1533) and nonmannitol (n=993) groups: propensity score-matched odds ratio of 0.90 (95% confidence interval, 0.75-1.09; P=0.30) and multivariable odds ratio of 0.87 (95% confidence interval, 0.71-1.07; P=0.18). Although a better outcome was suggested in patients with larger (≥15 mL) than those with smaller (<15 mL) baseline hematomas who received mannitol (odds ratio, 0.52 [95% confidence interval, 0.35-0.78] versus odds ratio, 0.91 [95% confidence interval, 0.72-1.15]; P homogeneity<0.03 in propensity score analyses), the association was not consistent in analyses across other cutoff points (≥10 and ≥20 mL) and for differing grades of neurological severity. Mannitol was not associated with excess serious adverse events. CONCLUSIONS: Mannitol seems safe but might not improve outcome in patients with acute intracerebral hemorrhage.
dc.identifier.citationStroke, October 2015, vol. 46, n°10, p. 2762-2767
dc.identifier.urihttp://hdl.handle.net/11447/332
dc.identifier.urihttp://dx.doi.org/10.1161/STROKEAHA.115.009357
dc.language.isoen_US
dc.publisherAmerican Heart Association, Inc
dc.subjectBlood pressure
dc.subjectCerebral hemorrhage
dc.subjectClinical trial
dc.subjectMannitol
dc.subjectPropensity score
dc.titleMannitol and Outcome in Intracerebral Hemorrhage: Propensity Score and Multivariable Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial 2 Results
dc.typeArtículo

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Mannitol and Outcome in Intracerebral Hemorrhage_ Propensity Score and Multivariable Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial 2 Results..pdf
Size:
188.13 KB
Format:
Adobe Portable Document Format
Description:
Abstract
Download

Collections

Artículos Medicina y Ciencias de la Salud

Implementado por OpenGeek Services