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3. Time for "Code ICH"? Workflow Metrics of Hyperacute Treatments and Outcome in Patients with Intracerebral Haemorrhage.

Author

Bettschen, Eva, Siepen, Bernhard M., Goeldlin, Martina B., Mueller, Madlaine, Buecke, Philipp, Prange, Ulrike, Meinel, Thomas R., Drop, Boudewijn R.H., Bervini, David, Dobrocky, Tomas, Kaesmacher, Johannes, Exadaktylos, Aristomenis K., Sauter, Thomas C., Volbers, Bastian, Arnold, Marcel, Jung, Simon, Fischer, Urs, Z'Graggen, Werner, and Seiffge, David

Subjects
SYSTOLIC blood pressure, CEREBRAL hemorrhage, NEUROSURGERY, BLOOD pressure, STROKE
Abstract

Introduction: Knowledge about uptake and workflow metrics of hyperacute treatments in patients with non-traumatic intracerebral haemorrhage (ICH) in the emergency department is scarce. Methods: Single-centre retrospective study of consecutive patients with ICH between 01/2018–08/2020. We assessed uptake and workflow metrics of acute therapies overall and according to referral mode (stroke code, transfer from other hospital, or other). Results: We enrolled 332 patients (age 73 years, IQR: 63–81 and GCS 14 points, IQR: 11–15, onset-to-admission time 284 min, IQR: 111–708 min), of whom 101 patients (35%) had lobar haematoma. Mode of referral was stroke code in 129 patients (38%), transfer from other hospital in 143 patients (43%), and arrival by other means in 60 patients (18%). Overall, 143 of 216 (66%) patients with systolic blood pressure >150 mm Hg received IV-antihypertensive treatment, and 67 of 76 (88%) on therapeutic oral anticoagulation received prothrombin complex concentrate treatment (PCC). Forty-six patients (14%) received any neurosurgical intervention within 3 h of admission. Median treatment times from admission to first IV-antihypertensive treatment were 38 min (IQR: 18–72 min) and 59 min (IQR: 37–111 min) for PCC, with significant differences according to mode of referral (p < 0.001) but not early arrival (≤6 h of onset, p = 0.92). The median time in the emergency department was 139 min (IQR: 85–220 min), and among patients with elevated blood pressure, only 44% achieved a successful control (<140 mm Hg) during ED stay. In multivariate analysis, code ICH concordant treatment was associated with significantly lower odds for in-hospital mortality (aOR 0.30, 95% CI: 0.12–0.73, p = 0.008) and non-significant trends towards better functional outcome measured using the modified Rankin scale score at 3 months (aOR for ordinal shift 0.54, 95% CI: 0.26–1.12, p = 0.097). Conclusion: Uptake of hyperacute therapies for ICH treatment in the ED is heterogeneous. Treatment delays are short, but not all patients achieve treatment targets during ED stay. Code ICH-concordant treatment may improve clinical outcomes. Further improvements seem achievable by advocating for a "code ICH" to streamline acute treatments. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Prevalence of right-to-left shunt in stroke patients with cancer.

Author

Steinauer, Fabienne, Bücke, Philipp, Buffle, Eric, Branca, Mattia, Göcmen, Jayan, Navi, Babak B, Liberman, Ava L, Boronylo, Anna, Clenin, Leander, Goeldlin, Martina, Lippert, Julian, Volbers, Bastian, Meinel, Thomas R, Seiffge, David, Mujanovic, Adnan, Kaesmacher, Johannes, Fischer, Urs, Arnold, Marcel, Pabst, Thomas, and Berger, Martin D

Subjects
ISCHEMIC stroke, PATENT foramen ovale, PARADOXICAL embolism, THERAPEUTIC embolization, TRANSESOPHAGEAL echocardiography
Abstract

Background and Objectives: Cancer is associated with an increased risk of acute ischemic stroke (AIS) and venous thromboembolism. The role of a cardiac right-to-left shunt (RLS) as a surrogate parameter for paradoxical embolism in cancer-related strokes is uncertain. We sought to investigate the relationship between the presence of an RLS and cancer in AIS patients. Methods: We included consecutive AIS patients hospitalized at our tertiary stroke center between January 2015 and December 2020 with available RLS status as detected on transesophageal echocardiography (TEE). Active cancers were retrospectively identified and the association with RLS was assessed with multivariable logistic regression and inverse probability of treatment weighting to minimize the ascertainment bias of having a TEE obtained. Results: Of the 2236 AIS patients included, 103 (4.6%) had active cancer, of whom 24 (23%) were diagnosed with RLS. An RLS was present in 774 out of the 2133 AIS patients without active cancer (36%). After adjustment and weighting, the absence of RLS was associated with active cancer (adjusted odds ratio (aOR) 2.29; 95% confidence interval (CI), 1.14–4.58). When analysis was restricted to patients younger than 60 years of age or those with a high-risk RLS (Risk of Paradoxical Embolism Score ⩾ 6), there was no association between RLS and cancer (aOR, 3.07; 95% CI, 0.79–11.88 and aOR, 0.56; 95% CI, 0.10–3.10, respectively). Conclusion: RLS was diagnosed less frequently in AIS patients with cancer than in cancer-free patients, suggesting that arterial sources may play a larger role in cancer-related strokes than paradoxical venous embolization. Future studies are needed to validate these findings and evaluate potential therapeutic implications, such as the general indication, or lack thereof, for patent foramen ovale (PFO) closure in this patient population. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Influence of bundled care treatment on functional outcome in patients with intracerebral hemorrhage.

Author

Mrochen, Anne, Yu Song, Harders, Verena, Sembill, Jochen A., Sprügel, Maximilian I., Hock, Stefan, Lang, Stefan, Engelhorn, Tobias, Kallmünzer, Bernd, Volbers, Bastian, and Kuramatsu, Joji B.

Subjects
SYSTOLIC blood pressure, BLOOD pressure, CEREBRAL hemorrhage, GLYCEMIC control, BODY temperature
Abstract

Background and aims: General guideline recommendations in patients with intracerebral hemorrhage (ICH) include blood pressure-, temperature- and glucose management. The therapeutic effect of such a "care bundle" (blood pressure lowering, glycemic control, and treatment of pyrexia) on clinical outcomes becomes increasingly established. For the present study, we aimed to investigate associations of strict bundled care treatment (BCT) with clinical outcomes and characterize associations with key outcome effectors such as hematoma enlargement (HE) and peak perihemorrhagic edema (PHE). Methods: We screened consecutive ICH patients (n = 1,322) from the prospective UKER-ICH cohort study. BCT was defined as achieving and maintaining therapeutic ranges for systolic blood pressure (110-160 mmHg), glucose (80-180 mg/dL), and body temperature (35.5-37.5°C) over the first 72 h. The primary outcome was the functional outcome at 12 months (modified Rankin Scale (mRS) 0-3). Secondary outcomes included mortality at 12 months, the occurrence of hematoma enlargement, and the development of peak perihemorrhagic edema. Confounding was addressed by a doubly robust methodology to calculate the absolute treatment effect (ATE) and by calculating e-values. Results: A total of 681 patients remained for analysis, and 182 patients fulfilled all three BCT criteria and were compared to 499 controls. The ATE of BCT to achieve the primary outcome was 9.3%, 95% CI (1.7 to 16.9), p < 0.001; e-value: 3.1, CI (1.8). Mortality at 12 months was significantly reduced by BCT [ATE: -12.8%, 95% CI (-19.8 to -5.7), p < 0.001; e-value: 3.8, CI (2.2)], and no association was observed for HE or peak PHE. Significant drivers of BCT effect on the primary outcome were systolic blood pressure control (ATE: 15.9%) and maintenance of normothermia (ATE: 10.9%). Conclusion: Strict adherence to this "care bundle" over the first 72 h during acute hospital care in patients with ICH was independently associated with improved functional long-term outcome, driven by systolic blood pressure control and maintenance of normothermia. Our findings strongly warrant prospective validation to determine the generalizability especially in Western countries. [ABSTRACT FROM AUTHOR]

Published
2024
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13. Absolute risk and predictors of the growth of acute spontaneous intracerebral haemorrhage: a systematic review and meta-analysis of individual patient data

Author

Hanley, Daniel F, Jr, Butcher, Kenneth S, Davis, Stephen, Gregson, Barbara, Lees, Kennedy R, Lyden, Patrick D, Mayer, Stephan A, Muir, Keith W, Steiner, Thorsten, Xie, Peng, Bakhshayesh, Babak, McDonald, Mark, Brott, Thomas, Pennati, Paolo, Parry-Jones, Adrian R, Smith, Craig J, Hopkins, Stephen J, Slevin, Mark, Campi, Veronica, Singh, Puneetpal, Papa, Francesca, Popa-Wagner, Aurel, Tudorica, Valeria, Takagi, Ryo, Teramoto, Akira, Weissenborn, Karin, Lanfermann, Heinrich, Al-Shahi Salman, Rustam, Frantzias, Joseph, Lee, Robert J, Battey, Thomas W K, Ayres, Alison M, Goldstein, Joshua N, Wang, Xia, Arima, Hisatomi, Hasegawa, Hitoshi, Oishi, Makoto, Godoy, Daniel A, Masotti, Luca, Dowlatshahi, Dar, Rodriguez-Luna, David, Molina, Carlos A, Jang, Dong-Kyu, Davalos, Antonio, Castillo, José, Yao, Xiaoying, Claassen, Jan, Volbers, Bastian, Kazui, Seiji, Okada, Yasushi, Fujimoto, Shigeru, Toyoda, Kazunori, Li, Qi, Khoury, Jane, Delgado, Pilar, Sabín, José Álvarez, Hernández-Guillamon, Mar, Prats-Sánchez, Luis, Cai, Chunyan, Kate, Mahesh P, McCourt, Rebecca, Venkatasubramanian, Chitra, Diringer, Michael N, Ikeda, Yukio, Worthmann, Hans, Ziai, Wendy C, d'Esterre, Christopher D, Aviv, Richard I, Raab, Peter, Murai, Yasuo, Zazulia, Allyson R, Seyedsaadat, Seyed Mohammad, Grotta, James C, Martí-Fàbregas, Joan, Montaner, Joan, Broderick, Joseph, Yamamoto, Haruko, Staykov, Dimitre, Connolly, E Sander, Selim, Magdy, Leira, Rogelio, Moon, Byung Hoo, Demchuk, Andrew M, Di Napoli, Mario, Fujii, Yukihiko, Anderson, Craig S, and Rosand, Jonathan

Published
2018
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20. Association of non-contrast CT markers with long-term functional outcome in deep intracerebral hemorrhage.

Author

Kölbl, Kathrin, Hock, Stefan W., Mingming Xu, Sembill, Jochen A., Mrochen, Anne, Balk, Stefanie, Lang, Stefan, Volbers, Bastian, Engelhorn, Tobias, Kallmünzer, Bernd, and Kuramatsu, Joji B.

Subjects
CEREBRAL hemorrhage, CLINICAL deterioration, BASAL ganglia, BLACK holes, DATABASES
Abstract

Objective: Hematoma expansion (HE) is the most important therapeutic target during acute care of patients with intracerebral hemorrhage (ICH). Imaging biomarkers such as non-contrast CT (NCCT) markers have been associated with increasing risk for HE. The aim of the present study was to evaluate the influence of NCCT markers with functional long-term outcome and with HE in patients with deep (basal ganglia and thalamus) ICH who represent an important subgroup of patients at the highest risk for functional deterioration with HE due to the eloquence of the affected brain region. Methods: From our prospective institutional database, all patients maximally treated with deep ICH were included and retrospectively analyzed. NCCT markers were recorded at diagnostic imaging, ICH volume characteristics were volumetrically evaluated, and all patients received follow-up imaging within 0-48 h. We explored associations of NCCT makers with unfavorable functional outcome, defined as modified Rankin scale 4-6, after 12 months and with HE. Bias and confounding were addressed by multivariable regression modeling. Results: In 322 patients with deep ICH, NCCT markers were distributed as follows: irregular shape: 69.6%, heterogenous density: 55.9%, hypodensities: 52.5%, island sign: 19.3%, black hole sign: 11.5%, and blend sign: 4.7%. Upon multivariable regression analyses, independent associations were documented with the functional outcome for irregular shape (aOR: 2.73, 95%CI: 1.42-5.22, p = 0.002), heterogenous density (aOR: 2.62, 95%CI: 1.40-4.90, p = 0.003) and island sign (aOR: 2.54, 95%CI: 1.05-6.14, p = 0.038), and with HE for heterogenous density (aOR: 5.01, 95%CI: 1.93-13.05, p = 0.001) and hypodensities (aOR: 3.75, 95%CI: 1.63-8.62, p = 0.002). Conclusion: NCCT markers are frequent in deep ICH patients and provide important clinical implications. Specifically, markers defined by diverging intrahematomal densities provided associations with a 5-times higher risk for HE and a 2.5-times higher likelihood for unfavorable functional long-term outcome. Hence, these markers allow the identification of patients with deep ICH at high risk for clinical deterioration due to HE. [ABSTRACT FROM AUTHOR]

Published
2024
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21. Atrial Fibrillation Detected before or after Stroke:Role of Anticoagulation

Author

Lyrer, Flurina, Zietz, Annaelle, Seiffge, David J., Koga, Masatoshi, Volbers, Bastian, Wilson, Duncan, Bonetti, Bruno, Schaedelin, Sabine, Gensicke, Henrik, Yoshimura, Sohei, Macha, Kosmas, Ambler, Gareth, Thilemann, Sebastian, Dittrich, Tolga, Inoue, Manabu, Miwa, Kaori, Wang, Ruihao, Siedler, Gabriela, Biburger, Luise, Brown, Martin M., Jäger, Rolf H., Muir, Keith, Traenka, Christopher, Tanaka, Kanta, Shiozawa, Masayuki, Bonati, Leo H., Peters, Nils, Lip, Gregory Y. H., Lyrer, Philippe A., Cappellari, Manuel, Toyoda, Kazunori, Kallmünzer, Bernd, Schwab, Stefan, Werring, David J., Engelter, Stefan T., De Marchis, Gian Marco, and Polymeris, Alexandros A.

Abstract

Background: Atrial fibrillation (AF) known before ischemic stroke (KAF) has been postulated to be an independent category with a recurrence risk higher than that of AF detected after stroke (AFDAS). However, it is unknown whether this risk difference is confounded by pre-existing anticoagulation, which is most common in KAF and also indicates a high ischemic stroke recurrence risk.Methods: Individual patient data analysis from 5 prospective cohorts of anticoagulated patients following AF-associated ischemic stroke. We compared the primary (ischemic stroke recurrence) and secondary outcome (all-cause death) among patients with AFDAS versus KAF and among anticoagulation-naïve versus previously anticoagulated patients using multivariable Cox, Fine-Gray models, and goodness-of-fit statistics to investigate the relative independent prognostic importance of AF-category and pre-existing anticoagulation.Results: Of 4,357 patients, 1,889 (43%) had AFDAS and 2,468 (57%) had KAF, while 3,105 (71%) were anticoagulation-naïve before stroke and 1,252 (29%) were previously anticoagulated. During 6,071 patient-years of follow-up, we observed 244 recurrent strokes and 661 deaths. Only pre-existing anticoagulation (but not KAF) was independently associated with a higher hazard for stroke recurrence in both Cox and Fine-Gray models. Models incorporating pre-existing anticoagulation showed better fit than those with AF category; adding AF-category did not result in better model fit. Neither pre-existing anticoagulation nor KAF were independently associated with death.Conclusion: Our findings challenge the notion that KAF and AFDAS are clinically relevant and distinct prognostic entities. Instead of attributing an independently high stroke recurrence risk to KAF, future research should focus on the causes of stroke despite anticoagulation to develop improved preventive treatments. ANN NEUROL 2023. Background: Atrial fibrillation (AF) known before ischemic stroke (KAF) has been postulated to be an independent category with a recurrence risk higher than that of AF detected after stroke (AFDAS). However, it is unknown whether this risk difference is confounded by pre-existing anticoagulation, which is most common in KAF and also indicates a high ischemic stroke recurrence risk.Methods: Individual patient data analysis from 5 prospective cohorts of anticoagulated patients following AF-associated ischemic stroke. We compared the primary (ischemic stroke recurrence) and secondary outcome (all-cause death) among patients with AFDAS versus KAF and among anticoagulation-naïve versus previously anticoagulated patients using multivariable Cox, Fine-Gray models, and goodness-of-fit statistics to investigate the relative independent prognostic importance of AF-category and pre-existing anticoagulation.Results: Of 4,357 patients, 1,889 (43%) had AFDAS and 2,468 (57%) had KAF, while 3,105 (71%) were anticoagulation-naïve before stroke and 1,252 (29%) were previously anticoagulated. During 6,071 patient-years of follow-up, we observed 244 recurrent strokes and 661 deaths. Only pre-existing anticoagulation (but not KAF) was independently associated with a higher hazard for stroke recurrence in both Cox and Fine-Gray models. Models incorporating pre-existing anticoagulation showed better fit than those with AF category; adding AF-category did not result in better model fit. Neither pre-existing anticoagulation nor KAF were independently associated with death.Conclusion: Our findings challenge the notion that KAF and AFDAS are clinically relevant and distinct prognostic entities. Instead of attributing an independently high stroke recurrence risk to KAF, future research should focus on the causes of stroke despite anticoagulation to develop improved preventive treatments. ANN NEUROL 2023.

Published
2023
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27. Atrial Fibrillation Detected before or after Stroke: Role of Anticoagulation.

Author

Lyrer, Flurina, Zietz, Annaelle, Seiffge, David J., Koga, Masatoshi, Volbers, Bastian, Wilson, Duncan, Bonetti, Bruno, Schaedelin, Sabine, Gensicke, Henrik, Yoshimura, Sohei, Macha, Kosmas, Ambler, Gareth, Thilemann, Sebastian, Dittrich, Tolga, Inoue, Manabu, Miwa, Kaori, Wang, Ruihao, Siedler, Gabriela, Biburger, Luise, and Brown, Martin M.

Subjects
ATRIAL fibrillation, ISCHEMIC stroke, ANTICOAGULANTS, STROKE
Abstract

Background: Atrial fibrillation (AF) known before ischemic stroke (KAF) has been postulated to be an independent category with a recurrence risk higher than that of AF detected after stroke (AFDAS). However, it is unknown whether this risk difference is confounded by pre‐existing anticoagulation, which is most common in KAF and also indicates a high ischemic stroke recurrence risk. Methods: Individual patient data analysis from 5 prospective cohorts of anticoagulated patients following AF‐associated ischemic stroke. We compared the primary (ischemic stroke recurrence) and secondary outcome (all‐cause death) among patients with AFDAS versus KAF and among anticoagulation‐naïve versus previously anticoagulated patients using multivariable Cox, Fine‐Gray models, and goodness‐of‐fit statistics to investigate the relative independent prognostic importance of AF‐category and pre‐existing anticoagulation. Results: Of 4,357 patients, 1,889 (43%) had AFDAS and 2,468 (57%) had KAF, while 3,105 (71%) were anticoagulation‐naïve before stroke and 1,252 (29%) were previously anticoagulated. During 6,071 patient‐years of follow‐up, we observed 244 recurrent strokes and 661 deaths. Only pre‐existing anticoagulation (but not KAF) was independently associated with a higher hazard for stroke recurrence in both Cox and Fine‐Gray models. Models incorporating pre‐existing anticoagulation showed better fit than those with AF category; adding AF‐category did not result in better model fit. Neither pre‐existing anticoagulation nor KAF were independently associated with death. Conclusion: Our findings challenge the notion that KAF and AFDAS are clinically relevant and distinct prognostic entities. Instead of attributing an independently high stroke recurrence risk to KAF, future research should focus on the causes of stroke despite anticoagulation to develop improved preventive treatments. ANN NEUROL 2023;94:43–54 [ABSTRACT FROM AUTHOR]

Published
2023
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28. Prognostic Accuracy of CTP Summary Maps in Patients with Large Vessel Occlusive Stroke and Poor Revascularization after Mechanical Thrombectomy—Comparison of Three Automated Perfusion Software Applications

Author

Muehlen, Iris, primary, Borutta, Matthias, additional, Siedler, Gabriela, additional, Engelhorn, Tobias, additional, Hock, Stefan, additional, Knott, Michael, additional, Hoelter, Philip, additional, Volbers, Bastian, additional, Schwab, Stefan, additional, and Doerfler, Arnd, additional

Published
2022
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29. Practical “1-2-3-4-Day” Rule for Starting Direct Oral Anticoagulants After Ischemic Stroke With Atrial Fibrillation: Combined Hospital-Based Cohort Study

Author

Kimura, Shunsuke, primary, Toyoda, Kazunori, additional, Yoshimura, Sohei, additional, Minematsu, Kazuo, additional, Yasaka, Masahiro, additional, Paciaroni, Maurizio, additional, Werring, David J., additional, Yamagami, Hiroshi, additional, Nagao, Takehiko, additional, Yoshimura, Shinichi, additional, Polymeris, Alexandros, additional, Zietz, Annaelle, additional, Engelter, Stefan T., additional, Kallmünzer, Bernd, additional, Cappellari, Manuel, additional, Chiba, Tetsuya, additional, Yoshimoto, Takeshi, additional, Shiozawa, Masayuki, additional, Kitazono, Takanari, additional, Koga, Masatoshi, additional, Todo, Kenichi, additional, Kimura, Kazumi, additional, Yagita, Yoshiki, additional, Furui, Eisuke, additional, Itabashi, Ryo, additional, Terasaki, Tadashi, additional, Shiokawa, Yoshiaki, additional, Hirano, Teruyuki, additional, Kamiyama, Kenji, additional, Nakagawara, Jyoji, additional, Takizawa, Shunya, additional, Homma, Kazunari, additional, Okuda, Satoshi, additional, Okada, Yasushi, additional, Tokunaga, Keisuke, additional, Kameda, Tomoaki, additional, Kario, Kazuomi, additional, Nagakane, Yoshinari, additional, Hasegawa, Yasuhiro, additional, Akiyama, Hisanao, additional, Shibuya, Satoshi, additional, Mochizuki, Hiroshi, additional, Ito, Yasuhiro, additional, Nakashima, Takahiro, additional, Matsuoka, Hideki, additional, Takamatsu, Kazuhiro, additional, Nishiyama, Kazutoshi, additional, Sato, Shoichiro, additional, Arihiro, Shoji, additional, Inoue, Manabu, additional, Takagi, Masahito, additional, Tanaka, Kanta, additional, Nagatsuka, Kazuyuki, additional, Yamaguchi, Takenori, additional, Hashimoto, Yoichiro, additional, Houkin, Kiyohiro, additional, Kitagawa, Kazuo, additional, Matsumoto, Masayasu, additional, Tanahashi, Norio, additional, Terayama, Yasuo, additional, Uchiyama, Shinichiro, additional, Mori, Etsuro, additional, Furukawa, Yutaka, additional, Kimura, Takeshi, additional, Kumon, Yoshiaki, additional, Nagata, Ken, additional, Nogawa, Shigeru, additional, Sakamoto, Tomohiro, additional, Hirai, Toshinori, additional, Kudo, Kohsuke, additional, Sasaki, Makoto, additional, Kobayashi, Shotai, additional, Hamasaki, Toshimitsu, additional, Giustozzi, Michela, additional, Acciarresi, Monica, additional, Agnelli, Giancarlo, additional, Caso, Valeria, additional, Bandini, Fabio, additional, Tsivgoulis, Georgios, additional, Yaghi, Shadi, additional, Furie, Karen L., additional, Tadi, Prasanna, additional, Becattini, Cecilia, additional, Zedde, Marialuisa, additional, Abdul-Rahim, Azmil H, additional, Lees, Kennedy R, additional, Alberti, Andrea, additional, Venti, Michele, additional, D’Amore, Cataldo, additional, Giulia Mosconi, Maria, additional, Anna Cimini, Ludovica, additional, Bovi, Paolo, additional, Carletti, Monica, additional, Rigatelli, Alberto, additional, Putaala, Jukka, additional, Tomppo, Liisa, additional, Tatlisumak, Turgut, additional, Marcheselli, Simona, additional, Pezzini, Alessandro, additional, Poli, Loris, additional, Padovani, Alessandro, additional, Vannucchi, Vieri, additional, Sohn, Sung-Il, additional, Lorenzini, Gianni, additional, Tassi, Rossana, additional, Guideri, Francesca, additional, Acampa, Maurizio, additional, Martini, Giuseppe, additional, Ntaios, George, additional, Athanasakis, George, additional, Makaritsis, Konstantinos, additional, Karagkiozi, Efstathia, additional, Vadikolias, Konstantinos, additional, Liantinioti, Chrissoula, additional, Chondrogianni, Maria, additional, Mumoli, Nicola, additional, Galati, Franco, additional, Sacco, Simona, additional, Tiseo, Cindy, additional, Corea, Francesco, additional, Ageno, Walter, additional, Bellesini, Marta, additional, Colombo, Giovanna, additional, Silvestrelli, Giorgio, additional, Ciccone, Alfonso, additional, Lanari, Alessia, additional, Scoditti, Umberto, additional, Denti, Licia, additional, Mancuso, Michelangelo, additional, Maccarrone, Miriam, additional, Ulivi, Leonardo, additional, Orlandi, Giovanni, additional, Giannini, Nicola, additional, Tassinari, Tiziana, additional, De Lodovici, Maria Luisa, additional, Rueckert, Christina, additional, Baldi, Antonio, additional, Toni, Danilo, additional, Letteri, Federica, additional, Giuntini, Martina, additional, Lotti, Enrico Maria, additional, Flomin, Yuriy, additional, Pieroni, Alessio, additional, Kargiotis, Odysseas, additional, Karapanayiotides, Theodore, additional, Monaco, Serena, additional, Baronello, Mario Maimone, additional, Csiba, Laszló, additional, Szabó, Lilla, additional, Chiti, Alberto, additional, Giorli, Elisa, additional, Del Sette, Massimo, additional, Imberti, Davide, additional, Zabzuni, Dorjan, additional, Doronin, Boris, additional, Volodina, Vera, additional, Michel, Patrik, additional, Vanacker, Peter, additional, Barlinn, Kristian, additional, Pallesen, Lars-Peder, additional, Barlinn, Jessica, additional, Deleu, Dirk, additional, Melikyan, Gayane, additional, Ibrahim, Faisal, additional, Akhtar, Naveed, additional, Gourbali, Vanessa, additional, Masotti, Luca, additional, Parry-Jones, Adrian, additional, Patterson, Chris, additional, Price, Christopher, additional, Elmarimi, Abduelbaset, additional, Parry, Anthea, additional, Nallasivam, Arumug, additional, Mohd Nor, Azlisham, additional, Esis, Bernard, additional, Bruce, David, additional, Roffe, Christine, additional, Holmes, Clare, additional, Cohen, David, additional, Hargroves, David, additional, Mangion, David, additional, Chadha, Dinesh, additional, Vahidassr, Djamil, additional, Manawadu, Dulka, additional, Giallombardo, Elio, additional, Warburton, Elizabeth, additional, Flossman, Enrico, additional, Gunathilagan, Gunaratam, additional, Proschel, Harald, additional, Emsley, Hedley, additional, Anwar, Ijaz, additional, Okwera, James, additional, Putterill, Janet, additional, O’Connell, Janice, additional, Bamford, John, additional, Corrigan, John, additional, Scott, Jon, additional, Birns, Jonathan, additional, Kee, Karen, additional, Saastamoinen, Kari, additional, Pasco, Kath, additional, Dani, Krishna, additional, Sekaran, Lakshmanan, additional, Choy, Lillian, additional, Iveson, Liz, additional, Mamun, Maam, additional, Sajid, Mahmud, additional, Cooper, Martin, additional, Burn, Matthew, additional, Smith, Matthew, additional, Power, Michael, additional, Davis, Michelle, additional, Smyth, Nigel, additional, Veltkamp, Roland, additional, Sharma, Pankaj, additional, Guyler, Paul, additional, O’Mahony, Paul, additional, Wilkinson, Peter, additional, Datta, Prabel, additional, Aghoram, Prasanna, additional, Marsh, Rachel, additional, Luder, Robert, additional, Meenakishundaram, Sanjeevikumar, additional, Subramonian, Santhosh, additional, Leach, Simon, additional, Ispoglou, Sissi, additional, Andole, Sreeman, additional, England, Timothy, additional, Manoj, Aravindakshan, additional, Harrington, Frances, additional, Rehman, Habib, additional, Sword, Jane, additional, Staals, Julie, additional, Mahawish, Karim, additional, Harkness, Kirsty, additional, Shaw, Louise, additional, McCormich, Michael, additional, Sprigg, Nikola, additional, Mansoor, Syed, additional, Krishnamurthy, Vinodh, additional, Lyrer, Philippe A, additional, Bonati, Leo H, additional, Seiffge, David J, additional, Traenka, Christopher, additional, Peters, Nils, additional, De Marchis, Gian Marco, additional, Thilemann, Sebastian, additional, Avramiotis, Nikolaos S, additional, Gensicke, Henrik, additional, Hert, Lisa, additional, Wagner, Benjamin, additional, Schaub, Fabian, additional, Meya, Louisa, additional, Fladt, Joachim, additional, Dittrich, Tolga, additional, Fisch, Urs, additional, Bonetti, Bruno, additional, Tomelleri, Giampaolo, additional, Micheletti, Nicola, additional, Zivelonghi, Cecilia, additional, Emiliani, Andrea, additional, Macha, Kosmas, additional, Siedler, Gabriela, additional, Stoll, Svenja, additional, Wang, Ruihao, additional, Volbers, Bastian, additional, Schwab, Stefan, additional, Haupenthal, David, additional, and Gaßmann, Luise, additional

Published
2022
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34. Etiology, 3-Month Functional Outcome and Recurrent Events in Non-Traumatic Intracerebral Hemorrhage

Author

Goeldlin, Martina B, Mueller, Achim, Siepen, Bernhard M, Mueller, Madlaine, Strambo, Davide, Michel, Patrik, Schaerer, Michael, Cereda, Carlo W, Bianco, Giovanni, Lindheimer, Florian, Berger, Christian, Medlin, Friedrich, Backhaus, Roland, Peters, Nils, Renaud, Susanne, Fisch, Loraine, Niederhaeuser, Julien, Carrera, Emmanuel, Dirren, Elisabeth, Bonvin, Christophe, Sturzenegger, Rolf, Kahles, Timo, Nedeltchev, Krassen, Kaegi, Georg, Vehoff, Jochen, Rodic, Biljana, Bolognese, Manuel, Schelosky, Ludwig, Salmen, Stephan, Mono, Marie-Luise, Polymeris, Alexandros A, Engelter, Stefan T, Lyrer, Philippe, Wegener, Susanne, Luft, Andreas R, Z'Graggen, Werner, Bervini, David, Volbers, Bastian, Dobrocky, Tomas, Kaesmacher, Johannes, Mordasini, Pasquale, Meinel, Thomas R, Arnold, Marcel, Fandino, Javier, Bonati, Leo H, Fischer, Urs, Seiffge, David J, and SSR Investigators

Subjects
Cerebral hemorrhage, Etiology, Ischemic stroke, Outcome, 610 Medicine & health, Neurology (clinical), cardiovascular diseases, Cardiology and Cardiovascular Medicine
Abstract

BACKGROUND AND PURPOSE Knowledge about different etiologies of non-traumatic intracerebral hemorrhage (ICH) and their outcomes is scarce. METHODS We assessed prevalence of pre-specified ICH etiologies and their association with outcomes in consecutive ICH patients enrolled in the prospective Swiss Stroke Registry (2014 to 2019). RESULTS We included 2,650 patients (mean±standard deviation age 72±14 years, 46.5% female, median National Institutes of Health Stroke Scale 8 [interquartile range, 3 to 15]). Etiology was as follows: hypertension, 1,238 (46.7%); unknown, 566 (21.4%); antithrombotic therapy, 227 (8.6%); cerebral amyloid angiopathy (CAA), 217 (8.2%); macrovascular cause, 128 (4.8%); other determined etiology, 274 patients (10.3%). At 3 months, 880 patients (33.2%) were functionally independent and 664 had died (25.1%). ICH due to hypertension had a higher odds of functional independence (adjusted odds ratio [aOR], 1.33; 95% confidence interval [CI], 1.00 to 1.77; P=0.05) and lower mortality (aOR, 0.64; 95% CI, 0.47 to 0.86; P=0.003). ICH due to antithrombotic therapy had higher mortality (aOR, 1.62; 95% CI, 1.01 to 2.61; P=0.045). Within 3 months, 4.2% of patients had cerebrovascular events. The rate of ischemic stroke was higher than that of recurrent ICH in all etiologies but CAA and unknown etiology. CAA had high odds of recurrent ICH (aOR, 3.38; 95% CI, 1.48 to 7.69; P=0.004) while the odds was lower in ICH due to hypertension (aOR, 0.42; 95% CI, 0.19 to 0.93; P=0.031). CONCLUSIONS Although hypertension is the leading etiology of ICH, other etiologies are frequent. One-third of ICH patients are functionally independent at 3 months. Except for patients with presumed CAA, the risk of ischemic stroke within 3 months of ICH was higher than the risk of recurrent hemorrhage.

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2021
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38. sj-pdf-1-eso-10.1177_23969873211061975 ��� Supplemental Material for Intracerebral haemorrhage volume, haematoma expansion and 3-month outcomes in patients on antiplatelets. A systematic review and meta-analysis

Author

Goeldlin, Martina B, Siepen, Bernhard M, Mueller, Madlaine, Volbers, Bastian, Z���Graggen, Werner, Bervini, David, Raabe, Andreas, Sprigg, Nikola, Fischer, Urs, and Seiffge, David J

Subjects
FOS: Clinical medicine, Cardiology, Medicine, 110904 Neurology and Neuromuscular Diseases
Abstract

Supplemental Material, sj-pdf-1-eso-10.1177_23969873211061975 for Intracerebral haemorrhage volume, haematoma expansion and 3-month outcomes in patients on antiplatelets. A systematic review and meta-analysis by Martina B Goeldlin, Bernhard M Siepen, Madlaine Mueller, Bastian Volbers, Werner Z���Graggen, David Bervini, Andreas Raabe, Nikola Sprigg, Urs Fischer and David J Seiffge in European Stroke Journal

Published
2021
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39. Disability-Adjusted Life-Years Associated With Intracerebral Hemorrhage and Secondary Injury

Author

Haupenthal, David, primary, Kuramatsu, Joji B., additional, Volbers, Bastian, additional, Sembill, Jochen A., additional, Mrochen, Anne, additional, Balk, Stefanie, additional, Hoelter, Philip, additional, Lücking, Hannes, additional, Engelhorn, Tobias, additional, Dörfler, Arnd, additional, Schwab, Stefan, additional, Huttner, Hagen B., additional, and Sprügel, Maximilian I., additional

Published
2021
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40. Influence of Early Enteral Nutrition on Clinical Outcomes in Neurocritical Care Patients With Intracerebral Hemorrhage

Author

Peng, Jianhua, primary, Volbers, Bastian, additional, Sprügel, Maximilian I., additional, Hoelter, Philip, additional, Engelhorn, Tobias, additional, Jiang, Yong, additional, Kuramatsu, Joji B., additional, Huttner, Hagen B., additional, Dörfler, Arnd, additional, Schwab, Stefan, additional, and Gerner, Stefan T., additional

Published
2021
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41. Impact of the coronavirus disease 2019 pandemic on stroke teleconsultations in Germany in the first half of 2020

Author

Vollmuth, Christoph, primary, Miljukov, Olga, additional, Abu‐Mugheisib, Mazen, additional, Angermaier, Anselm, additional, Barlinn, Jessica, additional, Busetto, Loraine, additional, Grau, Armin J., additional, Guenther, Albrecht, additional, Gumbinger, Christoph, additional, Hubert, Nikolai, additional, Hüttemann, Katrin, additional, Klingner, Carsten, additional, Naumann, Markus, additional, Palm, Frederick, additional, Remi, Jan, additional, Rücker, Viktoria, additional, Schessl, Joachim, additional, Schlachetzki, Felix, additional, Schuppner, Ramona, additional, Schwab, Stefan, additional, Schwartz, Andreas, additional, Trommer, Adrian, additional, Urbanek, Christian, additional, Volbers, Bastian, additional, Weber, Joachim, additional, Wojciechowski, Claudia, additional, Worthmann, Hans, additional, Zickler, Philipp, additional, Heuschmann, Peter U., additional, Haeusler, Karl Georg, additional, and Hubert, Gordian Jan, additional

Published
2021
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42. Impact of Statins on Hematoma, Edema, Seizures, Vascular Events, and Functional Recovery After Intracerebral Hemorrhage

Author

Sprügel, Maximilian I., primary, Kuramatsu, Joji B., additional, Volbers, Bastian, additional, Saam, Justina I., additional, Sembill, Jochen A., additional, Gerner, Stefan T., additional, Balk, Stefanie, additional, Hamer, Hajo M., additional, Lücking, Hannes, additional, Hölter, Philip, additional, Nolte, Christian H., additional, Scheitz, Jan F., additional, Rocco, Andrea, additional, Endres, Matthias, additional, and Huttner, Hagen B., additional

Published
2021
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43. Abstract P407: Etiology And Outcomes Of Non-traumatic Intracerebral Hemorrhage - Data From The Swiss Stroke Registry

Author

Goeldlin, Martina, primary, Mueller, Achim, additional, Siepen, Bernhard, additional, Mueller, Madlaine, additional, Strambo, Davide, additional, Cereda, Carlo W, additional, Berger, Christian, additional, Medlin, Friedrich, additional, Peters, Nils, additional, Renaud, Susanne, additional, Niederhaeuser, Julien, additional, Carrera, Emmanuel, additional, Bonvin, Christophe, additional, Sturzenegger, Rolf, additional, Kahles, Timo, additional, Nedeltchev, Krassen, additional, Kaegi, Georg, additional, Rodic, Biljana, additional, Bolognese, Manuel, additional, Schelosky, Ludwig, additional, Salmen, Stephan, additional, Mono, Marie-Luise, additional, Bonati, Leo H, additional, Polymeris, Alexandros, additional, Engelter, Stefan, additional, Lyrer, Philippe, additional, Wegener, Susanne, additional, Z’Graggen, Werner, additional, Bervini, David, additional, Volbers, Bastian, additional, Dobrocky, Tomas, additional, Fandino, Javier, additional, Arnold, Marcel, additional, Fischer, Urs M, additional, and Seiffge, David, additional

Published
2021
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