1. 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
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Jasmine Ng, Jerard Ross, Peter J. D. Andrews, Alan Jaap, Neil Turner, Helen Cook, Jon Stone, Michael G. K. Jones, Simon P. Hart, William Whiteley, Martin McKechnie, Billie Morrow, Graham McKillop, Laura Middleton, Sandra Dewar, Himanshu Shekhar, Susan Kealley, Laura Butler, Ashok Mathews, Donald Macleod, Neo Stavrinos, Andrew Elder, Ali Harmouche, Bethany Threlfall, Stuart McClellan, Frank Morrow, Ioannis P. Fouyas, Christopher P. Derry, Martin Dennis, Latana Munang, Peter Lange, Nicola L. Bell, David Summers, Judith Anderson, Robert Walker, Cathie Sudlow, Simon Leigh-Smith, Sarah Chambers, Robin Sellar, Patrick R. Taylor, Mark Hughes, Fiona Hughes, Jon Murchison, Richard Knight, Tim Russell, Moyra Masson, Donald Noble, Fiona Duncan, Claire Gordon, Ashok Jacob, M O Fitzpatrick, Randy Smith, Lynn McCallum, Belinda Weller, Katherine Jackson, Alasdair Gray, Angus B Gane, Siddharthan Chandran, Fiona Maxwell, Stanko Yordanov, Robert G. Will, Peter Foley, Patrick Statham, Henry Simms, Jon McCafferty, Colin Smith, Patricia Cantley, Alastair Crosswaite, Helen Spiers, Margarethe van Dijke, Yi Ng, Elizabeth Macdonald, Kate Enright, Gillian R. Kerr, Steven Makin, Katrina Dodds, Tom Fitzgerald, Simon Kerrigan, David Grant, Neil Hunter, Olayinka A Ogundipe, Claire Stirling, Astley Ainslie, Ian R. Whittle, Donald Farquhar, Jane Fothergill, Anne Knox, Andrew Jamieson, James M. Wilson, Alison Pollock, Andrew M. McIntosh, Andrew James Williams, Gillian Mead, Zoe Morris, Malcolm R. Macleod, Matthew J. Reed, Matthew Wilson, Colin B. Josephson, Brian Campbell, G. R. Nimmo, Brendan Sargent, Mark Rodrigues, Alastair Fitzgerald, Suvankar Pal, Colin J Mumford, Wendy Morley, Trish Elder-Gracie, Conor Maguire, Imran Liaquat, Sam Moultrie, James W. Dear, Peter Bodkin, Joanna M. Wardlaw, Johann R. Selvarajah, Antonia Torgersen, Iain Todd, Ralph Bouhaidar, Kristiina Rannikmäe, Syed Alhadad, Dilip Patel, Dave Caesar, Edinburgh Liberton Hospitals, Lynn M Myles, Fergus N. Doubal, Wendy Young, Kate Ahmad, Jonathan Rhodes, Anne Addison, Peter Sandercock, Rod Gibson, Seona Broadbent, Tim Morse, Gareth Clegg, Anant Kamat, Robin Henderson, Katherine Murray, Sudipto Ghosh, Sarah L. Keir, Joyce Stuart, Tom J Moullaali, Andrew J Coull, Rustam Al-Shahi Salman, Matthew King, Scott Ramsay, Linda Spence, Graham Mackay, Geraint Roberts, Mara Sittampalam, Laura Cunningham, Richard Davenport, Susan Duncan, Simon Dummer, Hamza Soleiman, Ross Murphy, James W. Ironside, Neshika Samarasekera, Paul Brennan, Peter Keston, Elaine Bisset, James J M Loan, Jonathan Carter, Brian Frier, David Hunt, Tracey Millar, Russell Hewett, Lewis Morrison, Mano Shanmuganathan, and Robin Grant
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Adult ,Male ,peri-hematomal edema ,medicine.medical_specialty ,Brain Edema ,030204 cardiovascular system & hematology ,survival ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Hematoma ,Edema ,Long term survival ,medicine ,Humans ,Spontaneous intracerebral hemorrhage ,Prospective Studies ,Aged ,Cerebral Hemorrhage ,Intracerebral hemorrhage ,Community based ,business.industry ,Research ,medicine.disease ,INCEPTION COHORT ,intracerebral hemorrhage ,radiology ,Surgery ,Stroke ,Neurology ,outcome ,Female ,medicine.symptom ,business ,Cohort study ,030217 neurology & neurosurgery - Abstract
Background Hospital-based studies have reported variable associations between outcome after spontaneous intracerebral hemorrhage and peri-hematomal edema volume. Aims 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. Methods 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. Results 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 ( R2 = 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). Conclusion 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. Data access statement Anonymized summary data may be requested from the corresponding author.
- Published
- 2021
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