1. Early Cognitive Impairment after Intracerebral Hemorrhage in the INTERACT1 Study
- Author
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Richard I. Lindley, Xia Wang, Thompson G. Robinson, Yongjun Cao, John Chalmers, Craig S. Anderson, and Shoujiang You
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Blood Pressure ,Pilot Projects ,03 medical and health sciences ,Cognition ,Sex Factors ,0302 clinical medicine ,Risk Factors ,medicine ,Humans ,Cognitive Dysfunction ,030212 general & internal medicine ,Cognitive impairment ,Antihypertensive Agents ,Aged ,Cerebral Hemorrhage ,Intracerebral hemorrhage ,National health ,business.industry ,Age Factors ,Middle Aged ,medicine.disease ,Medical research ,Treatment Outcome ,Neurology ,Emergency medicine ,Female ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery - Abstract
Background: Data on cognitive impairment after acute intracerebral hemorrhage (ICH) are limited. This study is aimed at determining the frequency and predictors of cognitive impairment among participants of the pilot phase, Intensive Blood Pressure (BP) Reduction in Acute Cerebral Hemorrhage Trial (INTERACT1). Methods: INTERACT1 was an open randomized trial of early intensive (target systolic BP Results: A total of 231 (64.5%) of 358 90-day survivors had MMSE scores for analyses, and 75 (32.5%) had cognitive impairment. In multivariable analysis, older age (OR 2.48, 95% CI 1.73–3.56 per 10-year increase; p < 0.001), female sex (OR 2.06, 95% CI 1.00–4.23; p = 0.049), prior ICH (OR 2.87, 95% CI 1.08–7.65; p = 0.035), high baseline National Institute of Health Stroke Scale score (OR 1.06, 95% CI 1.00–1.13; p = 0.044), and high mean systolic BP over the first 24 h post-randomization (OR 1.34, 95% CI 1.07–1.68/10 mm Hg increase; p = 0.011) were independently associated with cognitive impairment. Conclusions: One third of patients have significant cognitive impairment early after ICH, which is more frequent in the elderly, females, those with prior ICH, and more severe initial neurological deficit and with persistently high early systolic BP.
- Published
- 2017