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01-09-2020 | Stroke | Original Article

Acute hematoma expansion after spontaneous intracerebral hemorrhage: risk factors and impact on long-term prognosis

Authors: Agnese Sembolini, Michele Romoli, Umberto Pannacci, Giulio Gambaracci, Piero Floridi, Monica Acciarresi, Giancarlo Agnelli, Andrea Alberti, Michele Venti, Maurizio Paciaroni, Valeria Caso

Published in: Neurological Sciences | Issue 9/2020

Abstract

Introduction

Hematoma expansion (HE) after intracerebral hemorrhage (ICH) is associated with short-term mortality, but its impact on long-term prognosis is still unclear. The aim of this study was to evaluate the impact of HE on long-term survival and functional status after spontaneous ICH.

Methods

Consecutive patients admitted with spontaneous ICH were prospectively enrolled and followed up for a minimum of 2 years. We compared short-term (< 30 days) and long-term survival and functional status between ICH patients with HE (HE+) and those without (HE-). Main outcomes were mortality and poor outcome, defined as modified Rankin Scale ≥ 3. Secondary outcomes included recurrent ICH, admission to institutionalized care, and ischemic events (stroke, myocardial infarction, and systemic embolism).

Results

Overall, 140 patients were included (mean age 74.9 years, male 59.3%) and followed up for a mean of 2.25 years. HE+ patients (25.7%) had larger hematoma volume at admission (23.8 ml vs 15.3 ml, p < 0.05), higher NIHSS score (14.6 vs 10.5, p < 0.05) and higher cumulative mortality (59.3% vs 39.2%, p < 0.05) compared to HE- patients. Survival analysis showed that HE+ confers higher mortality and worse functional status at all time points. HE did not associate with secondary outcomes.

Discussion

HE translates into higher mortality and functional dependence over long-term follow-up. Strategies limiting HE might benefit long-term functional status.

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Title: Acute hematoma expansion after spontaneous intracerebral hemorrhage: risk factors and impact on long-term prognosis
Authors: Agnese Sembolini
Michele Romoli
Umberto Pannacci
Giulio Gambaracci
Piero Floridi
Monica Acciarresi
Giancarlo Agnelli
Andrea Alberti
Michele Venti
Maurizio Paciaroni
Valeria Caso
Publication date: 01-09-2020
Publisher: Springer International Publishing
Keywords: Stroke
Hematoma
Cerebral Hemorrhage
Published in: Neurological Sciences / Issue 9/2020
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-020-04356-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Acute hematoma expansion after spontaneous intracerebral hemorrhage: risk factors and impact on long-term prognosis

Abstract

Introduction

Methods

Results

Discussion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Discussion

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