Association Between Hematoma Expansion Severity and Outcome and Its Interaction With Baseline Intracerebral Hemorrhage Volume

作者全名："Morotti, Andrea; Boulouis, Gregoire; Nawabi, Jawed; Li, Qi; Charidimou, Andreas; Pasi, Marco; Schlunk, Frieder; Shoamanesh, Ashkan; Katsanos, Aristeidis H.; Mazzacane, Federico; Busto, Giorgio; Arba, Francesco; Brancaleoni, Laura; Giacomozzi, Sebastiano; Simonetti, Luigi; Warren, Andrew D.; Laudisi, Michele; Cavallini, Anna; Gurol, M. Edip; Viswanathan, Anand; Zini, Andrea; Casetta, Ilaria; Fainardi, Enrico; Greenberg, Steven M.; Padovani, Alessandro; Rosand, Jonathan; Goldstein, Joshua N."

作者地址："[Morotti, Andrea] ASST Spedali Civili, Dept Neurol Sci & Vis, Neurol Unit, Brescia, Italy; [Boulouis, Gregoire] Univ Hosp Tours, Neuroradiol Dept, Tours, France; [Nawabi, Jawed] Free Univ Berlin, Berlin Inst Hlth, Dept Radiol CCM, Humboldt Univ Berlin, Campus Mitte, Berlin, Germany; [Nawabi, Jawed; Schlunk, Frieder] BIH Biomed Innovat Acad, Berlin Inst Hlth BIH, Berlin, Germany; [Li, Qi] Chongqing Med Univ, Affiliated Hosp 1, Dept Neurol, Chongqing, Peoples R China; [Li, Qi] Anhui Med Univ, Affiliated Hosp 2, Dept Neurol, Hefei, Peoples R China; [Charidimou, Andreas] Boston Univ, Med Ctr, Dept Neurol, Boston, MA USA; [Charidimou, Andreas] Boston Univ, Sch Med, Boston, MA USA; [Pasi, Marco] Univ Hosp Tours, Neurol Dept, Tours, France; [Schlunk, Frieder] Charite Univ Med Berlin, Dept Neuroradiol, Berlin, Germany; [Schlunk, Frieder] Free Univ Berlin, Berlin, Germany; [Schlunk, Frieder] Humboldt Univ, Berlin, Germany; [Shoamanesh, Ashkan; Katsanos, Aristeidis H.] McMaster Univ, Populat Hlth Res Inst, Div Neurol, Hamilton, ON, Canada; [Mazzacane, Federico; Cavallini, Anna] IRCCS Fdn Mondino, UO Neurol Urgenza & Stroke Unit, Pavia, Italy; [Busto, Giorgio; Fainardi, Enrico] Univ Firenze, Dept Biomed Expt & Clin Neuroradiol, AOU Careggi, Florence, Italy; [Arba, Francesco] AOU Careggi, Stroke Unit, Florence, Italy; [Brancaleoni, Laura; Giacomozzi, Sebastiano; Zini, Andrea] IRCCS Ist Sci Neurol Bologna, Osped Maggiore, UOC Neurol & Rete Stroke Metropolitana, Bologna, Italy; [Simonetti, Luigi] RCCS Ist Sci Neurol Bologna, Osped Maggiore, Uniadi Neuroradiol, Bologna, Italy; [Warren, Andrew D.; Gurol, M. Edip; Viswanathan, Anand; Greenberg, Steven M.; Rosand, Jonathan; Goldstein, Joshua N.] Harvard Med Sch, Massachusetts Gen Hosp, JP Kistler Stroke Res Ctr, Dept Neurol, Boston, MA USA; [Laudisi, Michele; Casetta, Ilaria] Univ Ferrara, Osped Univ S Anna, Dipartimento Sci Biomed & Chirurg Specialist, Clin Neurol, Ferrara, Italy; [Padovani, Alessandro] Univ Brescia, Dept Clin & Expt Sci, Neurol Unit, Brescia, Italy; [Rosand, Jonathan] Harvard Med Sch, Massachusetts Gen Hosp, Dept Neurol, Div Neurocrit Care & Emergency Neurol, Boston, MA USA; [Rosand, Jonathan; Goldstein, Joshua N.] Massachusetts Gen Hosp, Henry & Allison McCance Ctr Brain Hlth, Boston, MA USA; [Goldstein, Joshua N.] Massachusetts Gen Hosp, Dept Emergency Med, Boston, MA USA"

通信作者："Morotti, A (通讯作者)，ASST Spedali Civili, Dept Neurol Sci & Vis, Neurol Unit, Brescia, Italy."

来源：NEUROLOGY

ESI学科分类：NEUROSCIENCE & BEHAVIOR

WOS号：WOS:001093994200010

JCR分区：Q1

影响因子：7.7

年份：2023

卷号：101

期号：16

开始页：E1606

结束页：E1613

文献类型：Article

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摘要："Background and Objectives Hematoma expansion (HE) is a major determinant of neurologic deterioration and poor outcome in intracerebral hemorrhage (ICH) and represents an appealing therapeutic target. We analyzed the prognostic effect of different degrees of HE.Methods This was a retrospective analysis of patients with ICH admitted at 8 academic institutions in Italy, Germany, Canada, China, and the United States. All patients underwent baseline and follow-up imaging for HE assessment. Relative HE (rHE) was classified as follows: none (<0%), mild (0%-33%), moderate (33.1%-66%), and severe (>66%). Absolute HE (aHE) was classified as none (<0 mL), mild (0-6.0 mL), moderate (6.1-12.5 mL), and severe (>12.5 mL). Predictors of poor functional outcome (90 days modified Rankin Scale 4-6) were explored with logistic regression.Results We included 2,163 patients, of whom 1,211 (56.0%) had poor outcome. The occurrence of severe aHE or rHE was more common in patients with unfavorable outcome (13.9% vs 6.5%, p < 0.001 and 18.3% vs 7.2%, p < 0.001 respectively). This association was confirmed in logistic regression (rHE odds ratio [OR] 1.98, 95% CI 1.38-2.82, p < 0.001; aHE OR 1.73, 95% CI 1.23-2.45, p = 0.002) while there was no association between mild or moderate HE and poor outcome. The association between severe HE and poor outcome was significant only in patients with baseline ICH volume below 30 mL.Discussion The strongest association between HE and outcome was observed in patients with smaller initial volume experiencing severe HE. These findings may inform clinical trial design and guide clinicians in selecting patients for antiexpansion therapies."

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