1. Association of large core middle cerebral artery stroke and hemorrhagic transformation with hospitalization outcomes
- Author
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Jack E. Pohlmann, Ivy So Yeon Kim, Benjamin Brush, Krishna M. Sambhu, Lucas Conti, Hanife Saglam, Katie Milos, Lillian Yu, Michael F. M. Cronin, Oluwafemi Balogun, Stefanos Chatzidakis, Yihan Zhang, Ludovic Trinquart, Qiuxi Huang, Stelios M. Smirnakis, Emelia J. Benjamin, Josée Dupuis, David M. Greer, and Charlene J. Ong
- Subjects
Medicine ,Science - Abstract
Abstract Historically, investigators have not differentiated between patients with and without hemorrhagic transformation (HT) in large core ischemic stroke at risk for life-threatening mass effect (LTME) from cerebral edema. Our objective was to determine whether LTME occurs faster in those with HT compared to those without. We conducted a two-center retrospective study of patients with ≥ 1/2 MCA territory infarct between 2006 and 2021. We tested the association of time-to-LTME and HT subtype (parenchymal, petechial) using Cox regression, controlling for age, mean arterial pressure, glucose, tissue plasminogen activator, mechanical thrombectomy, National Institute of Health Stroke Scale, antiplatelets, anticoagulation, temperature, and stroke side. Secondary and exploratory outcomes included mass effect-related death, all-cause death, disposition, and decompressive hemicraniectomy. Of 840 patients, 358 (42.6%) had no HT, 403 (48.0%) patients had petechial HT, and 79 (9.4%) patients had parenchymal HT. LTME occurred in 317 (37.7%) and 100 (11.9%) had mass effect-related deaths. Parenchymal (HR 8.24, 95% CI 5.46–12.42, p
- Published
- 2024
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