Thursday, June 18, 2020

Longer term stroke risk in intracerebral haemorrhage survivors

Useless. NOTHING on how to prevent this from happening.  A hell of a lot of mentors and senior researchers need retraining  on the point of stroke research. Helping stroke survivors, usually to 100% recovery.

Longer term stroke risk in intracerebral haemorrhage survivors



  1. Gargi Banerjee1,
  2. Duncan Wilson1,
  3. Gareth Ambler2,
  4. Isabel Charlotte Hostettler1,
  5. Clare Shakeshaft1,
  6. Hannah Cohen3,
  7. Tarek Yousry4,
  8. Rustam Al-Shahi Salman5,
  9. Gregory Y H Lip6,7,
  10. Henry Houlden8,
  11. Keith W Muir9,
  12. Martin M Brown1,
  13. Hans Rolf Jäger4,
  14. David J Werring1
  15. on behalf of the CROMIS-2 collaborators

Author affiliations

Abstract

Objective To evaluate the influence of intracerebral haemorrhage (ICH) location on stroke outcomes.
Methods 
We included patients recruited to a UK hospital-based, multicentre observational study of adults with imaging confirmed spontaneous ICH. The outcomes of interest were occurrence of a cerebral ischaemic event (either stroke or transient ischaemic attack) or a further ICH following study entry. Haematoma location was classified as lobar or non-lobar.
Results 
All 1094 patients recruited to the CROMIS-2 (Clinical Relevance of Microbleeds in Stroke) ICH study were included (mean age 73.3 years; 57.4% male). There were 45 recurrent ICH events (absolute event rate (AER) 1.88 per 100 patient-years); 35 in patients presenting with lobar ICH (n=447, AER 3.77 per 100 patient-years); and 9 in patients presenting with non-lobar ICH (n=580, AER 0.69 per 100 patient-years). Multivariable Cox regression found that lobar ICH was associated with ICH recurrence (HR 8.96, 95% CI 3.36 to 23.87, p<0.0001); similar results were found in multivariable completing risk analyses. There were 70 cerebral ischaemic events (AER 2.93 per 100 patient-years); 29 in patients presenting with lobar ICH (AER 3.12 per 100 patient-years); and 39 in patients with non-lobar ICH (AER 2.97 per 100 patient-years). Multivariable Cox regression found no association with ICH location (HR 1.13, 95% CI 0.66 to 1.92, p=0.659). Similar results were seen in completing risk analyses.
Conclusions 
 In ICH survivors, lobar ICH location was associated with a higher risk of recurrent ICH events than non-lobar ICH; ICH location did not influence risk of subsequent ischaemic events.
Trial registration number NCT02513316.
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