Predictors and Prognostic Impact of Hematoma Expansion in Infratentorial Cerebral Hemorrhage

作者全名："Pezzini, Debora; Nawabi, Jawed; Schlunk, Frieder; Li, Qi; Mazzacane, Federico; Busto, Giorgio; Scola, Elisa; Arba, Francesco; Brancaleoni, Laura; Giacomozzi, Sebastiano; Simonetti, Luigi; Laudisi, Michele; Cavallini, Anna; Katsanos, Aristeidis H.; Shoamanesh, Ashkan; Zini, Andrea; Casetta, Ilaria; Fainardi, Enrico; Morotti, Andrea; Padovani, Alessandro"

作者地址："[Pezzini, Debora; Padovani, Alessandro] Univ Brescia, Dept Clin & Expt Sci, Neurol Unit, Piazzale Spedali Civili 1, I-25123 Brescia, Italy; [Nawabi, Jawed] Free Univ Berlin, Dept Radiol CCM, Berlin Inst Hlth, Humboldt Univ Berlin,Charite Univ Med Berlin, Campus Mitte, Berlin, Germany; [Nawabi, Jawed; Schlunk, Frieder] Berlin Inst Hlth BIH, BIH Biomed Innovat Acad, Berlin, Germany; [Schlunk, Frieder] Humboldt Univ, Charite Univ Med Berlin, Dept Neuroradiol, Freie Univ Berlin, Berlin, Germany; [Li, Qi] Chongqing Med Univ, Dept Neurol, Affiliated Hosp 1, Chongqing, Peoples R China; [Mazzacane, Federico] IRCCS Fdn Mondino, UC Malattie Cerebrovasc & Stroke Unit, Pavia, Italy; [Busto, Giorgio; Scola, Elisa] Careggi Univ Hosp, Dept Radiol, Neuroradiol Unit, Florence, Italy; [Arba, Francesco] Careggi Univ Hosp, Stroke Unit, Florence, Italy; [Brancaleoni, Laura; Giacomozzi, Sebastiano] Osped Maggiore Bologna, IRCCS Ist Sci Neurol Bologna, UOC Neurol & Rete Stroke Metropolitana, Bologna, Italy; [Simonetti, Luigi] Osped Maggiore Bologna, IRCCS Ist Sci Neurol Bologna, UO SSI Neuroradiol, Bologna, Italy; [Laudisi, Michele; Casetta, Ilaria] Univ Ferrara, Osped Univ S Anna, Clin Neurol, Dipartimento Sci Biomed & Chirurg Specialistiche, Ferrara, Italy; [Katsanos, Aristeidis H.; Shoamanesh, Ashkan] McMaster Univ, Div Neurol, Populat Hlth Res Inst, Hamilton, ON, Canada; [Katsanos, Aristeidis H.] Natl & Kapodistrian Univ Athens, Sch Med, Attikon Hosp, Dept Neurol 2, Athens, Greece; [Fainardi, Enrico] Univ Florence, Dept Expt & Clin Biomed Sci, Neuroradiol Unit, Florence, Italy; [Morotti, Andrea; Padovani, Alessandro] ASST Spedali Civili, Dept Neurol Sci & Vis, Neurol Unit, Brescia, Italy"

通信作者："Pezzini, D (通讯作者)，Univ Brescia, Dept Clin & Expt Sci, Neurol Unit, Piazzale Spedali Civili 1, I-25123 Brescia, Italy."

来源：NEUROCRITICAL CARE

ESI学科分类：NEUROSCIENCE & BEHAVIOR

WOS号：WOS:001061911500001

JCR分区：Q2

影响因子：3.1

年份：2024

卷号：40

期号：2

开始页：707

结束页：714

文献类型：Article

关键词：Stroke; Intracerebral hemorrhage; Infratentorial; Noncontrast computed tomography; Hypodensity

摘要："Background: Hematoma expansion (HE) is common and predicts poor outcome in patients with supratentorial intracerebral hemorrhage (ICH). We investigated the predictors and prognostic impact of HE in infratentorial ICH. Methods: We conducted a retrospective analysis of patients with brainstem and cerebellar ICH admitted at seven sites. Noncontrast computed tomography images were analyzed for the presence of hypodensities according to validated criteria, defined as any hypodense region strictly encapsulated within the hemorrhage with any shape, size, and density. Occurrence of HE (defined as > 33% and/or > 6-mL growth) and mortality at 90 days were the outcomes of interest. Their predictors were investigated using logistic regression with backward elimination at p < 0.1. Logistic regression models for HE were adjusted for baseline ICH volume, antiplatelet and anticoagulant treatment, onset to computed tomography time, and presence of hypodensities. The logistic regression model for mortality accounted for the ICH score and HE. Results: A total of 175 patients were included (median age 75 years, 40.0% male), of whom 38 (21.7%) had HE and 43 (24.6%) died within 90 days. Study participants with HE had a higher frequency of hypodensities (44.7 vs. 24.1%, p = 0.013), presentation within 3 h from onset (39.5 vs. 24.8%, p = 0.029), and 90-day mortality (44.7 vs. 19.0%, p = 0.001). Hypodensities remained independently associated with HE after adjustment for confounders (odds ratio 2.44, 95% confidence interval 1.13-5.25, p = 0.023). The association between HE and mortality remained significant in logistic regression (odds ratio 3.68, 95% confidence interval 1.65-8.23, p = 0.001). Conclusion: Early presentation and presence of noncontrast computed tomography hypodensities were independent predictors of HE in infratentorial ICH, and the occurrence of HE had an independent prognostic impact in this population."

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