Longer term stroke risk in intracerebral haemorrhage survivors

, CROMIS-2 collaborators (2020) Longer term stroke risk in intracerebral haemorrhage survivors. Journal of Neurology, Neurosurgery and Psychiatry, 91 (8). pp. 840-845. ISSN 0022-3050

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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.

Item Type:
Journal Article
Journal or Publication Title:
Journal of Neurology, Neurosurgery and Psychiatry
Additional Information:
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Uncontrolled Keywords:
/dk/atira/pure/subjectarea/asjc/1200/1201
Subjects:
ID Code:
154117
Deposited By:
Deposited On:
22 Apr 2021 15:00
Refereed?:
Yes
Published?:
Published
Last Modified:
16 Jun 2021 08:27