Subarachnoid extension of intracerebral hemorrhage and 90-day outcomes in INTERACT2

Guofang Chen, Hisatomi Arima, Guojun Wu, Emma Heeley, Candice Delcourt, Peiying Zhang, Alejandro Rabinstein, Thompson Robinson, Christian Stapf, Yining Huang, Lili Song, Jie Yang, Xia Wang, Qiang Li, Xiaoying Chen, John Chalmers, Craig Anderson

Research output: Contribution to journalArticle

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Abstract

Background and Purpose-The prognostic significance of subarachnoid extension of intracerebral hemorrhage was determined in the INTEnsive blood pressure Reduction in Acute Cerebral hemorrhage Trial (INTERACT2) study. Methods-INTERACT2 was an open randomized controlled trial of early intensive compared with guideline-recommended blood pressure lowering in patients with elevated systolic blood pressure within 6 hours of intracerebral hemorrhage. Independent predictors of death or major disability (scores 3-6 on the modified Rankin Scale) at 90 days were analyzed in logistic regression models. Results-Of 2582 participants, 192 (7%) had subarachnoid extension, which was associated with larger hematoma volumes (P>0.0001) and higher National Institute of Health Stroke Scale score (P>0.0001). Subarachnoid extension predicted death or major disability at 90 days (71% versus 53%; unadjusted odds ratio, 2.25; 95% confidence interval, 1.63-3.10; P>0.0001). The association remained significant after adjusting for age, region, lipid-lowering therapy, systolic blood pressure, glucose, location of hematoma, intraventricular extension, and randomized treatment (odds ratio, 2.17; 95% confidence interval, 1.50-3.14; P>0.0001), but not after further adjustment for baseline hematoma volume (P=0.62). Conclusions-Subarachnoid extension of intracerebral hemorrhage is associated with poor prognosis, which is determined by a larger volume of the underlying intraparenchymal hematoma. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00716079.

Original languageEnglish (US)
Pages (from-to)258-260
Number of pages3
JournalStroke
Volume45
Issue number1
DOIs
StatePublished - Jan 1 2014

Fingerprint

Cerebral Hemorrhage
Blood Pressure
Hematoma
Logistic Models
Odds Ratio
Confidence Intervals
National Institutes of Health (U.S.)
Blood Glucose
Randomized Controlled Trials
Stroke
Clinical Trials
Guidelines
Lipids
Therapeutics

Keywords

  • Assessment
  • Cerebral hemorrhage
  • Clinical trial
  • Outcomes

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Chen, G., Arima, H., Wu, G., Heeley, E., Delcourt, C., Zhang, P., ... Anderson, C. (2014). Subarachnoid extension of intracerebral hemorrhage and 90-day outcomes in INTERACT2. Stroke, 45(1), 258-260. https://doi.org/10.1161/Strokeaha.113.003524

Subarachnoid extension of intracerebral hemorrhage and 90-day outcomes in INTERACT2. / Chen, Guofang; Arima, Hisatomi; Wu, Guojun; Heeley, Emma; Delcourt, Candice; Zhang, Peiying; Rabinstein, Alejandro; Robinson, Thompson; Stapf, Christian; Huang, Yining; Song, Lili; Yang, Jie; Wang, Xia; Li, Qiang; Chen, Xiaoying; Chalmers, John; Anderson, Craig.

In: Stroke, Vol. 45, No. 1, 01.01.2014, p. 258-260.

Research output: Contribution to journalArticle

Chen, G, Arima, H, Wu, G, Heeley, E, Delcourt, C, Zhang, P, Rabinstein, A, Robinson, T, Stapf, C, Huang, Y, Song, L, Yang, J, Wang, X, Li, Q, Chen, X, Chalmers, J & Anderson, C 2014, 'Subarachnoid extension of intracerebral hemorrhage and 90-day outcomes in INTERACT2', Stroke, vol. 45, no. 1, pp. 258-260. https://doi.org/10.1161/Strokeaha.113.003524
Chen G, Arima H, Wu G, Heeley E, Delcourt C, Zhang P et al. Subarachnoid extension of intracerebral hemorrhage and 90-day outcomes in INTERACT2. Stroke. 2014 Jan 1;45(1):258-260. https://doi.org/10.1161/Strokeaha.113.003524
Chen, Guofang ; Arima, Hisatomi ; Wu, Guojun ; Heeley, Emma ; Delcourt, Candice ; Zhang, Peiying ; Rabinstein, Alejandro ; Robinson, Thompson ; Stapf, Christian ; Huang, Yining ; Song, Lili ; Yang, Jie ; Wang, Xia ; Li, Qiang ; Chen, Xiaoying ; Chalmers, John ; Anderson, Craig. / Subarachnoid extension of intracerebral hemorrhage and 90-day outcomes in INTERACT2. In: Stroke. 2014 ; Vol. 45, No. 1. pp. 258-260.
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abstract = "Background and Purpose-The prognostic significance of subarachnoid extension of intracerebral hemorrhage was determined in the INTEnsive blood pressure Reduction in Acute Cerebral hemorrhage Trial (INTERACT2) study. Methods-INTERACT2 was an open randomized controlled trial of early intensive compared with guideline-recommended blood pressure lowering in patients with elevated systolic blood pressure within 6 hours of intracerebral hemorrhage. Independent predictors of death or major disability (scores 3-6 on the modified Rankin Scale) at 90 days were analyzed in logistic regression models. Results-Of 2582 participants, 192 (7{\%}) had subarachnoid extension, which was associated with larger hematoma volumes (P>0.0001) and higher National Institute of Health Stroke Scale score (P>0.0001). Subarachnoid extension predicted death or major disability at 90 days (71{\%} versus 53{\%}; unadjusted odds ratio, 2.25; 95{\%} confidence interval, 1.63-3.10; P>0.0001). The association remained significant after adjusting for age, region, lipid-lowering therapy, systolic blood pressure, glucose, location of hematoma, intraventricular extension, and randomized treatment (odds ratio, 2.17; 95{\%} confidence interval, 1.50-3.14; P>0.0001), but not after further adjustment for baseline hematoma volume (P=0.62). Conclusions-Subarachnoid extension of intracerebral hemorrhage is associated with poor prognosis, which is determined by a larger volume of the underlying intraparenchymal hematoma. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00716079.",
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AU - Chen, Guofang

AU - Arima, Hisatomi

AU - Wu, Guojun

AU - Heeley, Emma

AU - Delcourt, Candice

AU - Zhang, Peiying

AU - Rabinstein, Alejandro

AU - Robinson, Thompson

AU - Stapf, Christian

AU - Huang, Yining

AU - Song, Lili

AU - Yang, Jie

AU - Wang, Xia

AU - Li, Qiang

AU - Chen, Xiaoying

AU - Chalmers, John

AU - Anderson, Craig

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N2 - Background and Purpose-The prognostic significance of subarachnoid extension of intracerebral hemorrhage was determined in the INTEnsive blood pressure Reduction in Acute Cerebral hemorrhage Trial (INTERACT2) study. Methods-INTERACT2 was an open randomized controlled trial of early intensive compared with guideline-recommended blood pressure lowering in patients with elevated systolic blood pressure within 6 hours of intracerebral hemorrhage. Independent predictors of death or major disability (scores 3-6 on the modified Rankin Scale) at 90 days were analyzed in logistic regression models. Results-Of 2582 participants, 192 (7%) had subarachnoid extension, which was associated with larger hematoma volumes (P>0.0001) and higher National Institute of Health Stroke Scale score (P>0.0001). Subarachnoid extension predicted death or major disability at 90 days (71% versus 53%; unadjusted odds ratio, 2.25; 95% confidence interval, 1.63-3.10; P>0.0001). The association remained significant after adjusting for age, region, lipid-lowering therapy, systolic blood pressure, glucose, location of hematoma, intraventricular extension, and randomized treatment (odds ratio, 2.17; 95% confidence interval, 1.50-3.14; P>0.0001), but not after further adjustment for baseline hematoma volume (P=0.62). Conclusions-Subarachnoid extension of intracerebral hemorrhage is associated with poor prognosis, which is determined by a larger volume of the underlying intraparenchymal hematoma. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00716079.

AB - Background and Purpose-The prognostic significance of subarachnoid extension of intracerebral hemorrhage was determined in the INTEnsive blood pressure Reduction in Acute Cerebral hemorrhage Trial (INTERACT2) study. Methods-INTERACT2 was an open randomized controlled trial of early intensive compared with guideline-recommended blood pressure lowering in patients with elevated systolic blood pressure within 6 hours of intracerebral hemorrhage. Independent predictors of death or major disability (scores 3-6 on the modified Rankin Scale) at 90 days were analyzed in logistic regression models. Results-Of 2582 participants, 192 (7%) had subarachnoid extension, which was associated with larger hematoma volumes (P>0.0001) and higher National Institute of Health Stroke Scale score (P>0.0001). Subarachnoid extension predicted death or major disability at 90 days (71% versus 53%; unadjusted odds ratio, 2.25; 95% confidence interval, 1.63-3.10; P>0.0001). The association remained significant after adjusting for age, region, lipid-lowering therapy, systolic blood pressure, glucose, location of hematoma, intraventricular extension, and randomized treatment (odds ratio, 2.17; 95% confidence interval, 1.50-3.14; P>0.0001), but not after further adjustment for baseline hematoma volume (P=0.62). Conclusions-Subarachnoid extension of intracerebral hemorrhage is associated with poor prognosis, which is determined by a larger volume of the underlying intraparenchymal hematoma. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00716079.

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