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Long-term functional decline of spontaneous intracerebral haemorrhage survivors
- Source :
- Journal of neurology, neurosurgery, and psychiatry. 92(3)
- Publication Year :
- 2020
-
Abstract
- ObjectiveTo identify in patients who survived 6 months after a spontaneous intracerebral haemorrhage (ICH) baseline characteristics and new clinical events associated with functional decline.MethodsIn a single-centre study, we prospectively included 6-month survivors with a modified Rankin Scale (mRS) score 0–3. We defined functional decline by a transition to mRS 4–5. We evaluated associations of baseline characteristics and new clinical events with functional decline, using univariate and multivariable models.ResultsOf 560 patients, 174 (31%) had an mRS score 0–3 at 6 months. During a median follow-up of 9 years (IQR 8.1–9.5), 40 (23%) converted to mRS 4–5. Age, diabetes mellitus, ICH volume and higher mRS scores at 6 months were independently associated with functional decline. Among baseline MRI markers, presence of strictly lobar cerebral microbleeds (CMBs), and mixed lobar and deep CMBs were independently associated with functional decline. When new clinical events occurring during follow-up were added in multivariable models, age (cause-specific HR (CSHR): 1.07; 95% CI: 1.03 to 1.11), ICH volume (CSHR: 1.03; 95% CI: 1.01 to 1.06), mRS score at 6 months (CSHR per 1 point increase 1.61, 95% CI 1.07 to 2.43), occurrence of dementia (CSHR: 3.81, 95% CI: 1.78 to 8.16) and occurrence of any stroke (CSHR: 4.29, 95% CI: 1.80 to 10.22) remained independently associated with transition to mRS 4–5.InterpretationAlmost one-fourth of patients with spontaneous ICH developed a functional decline over time. Age, ICH volume, higher mRS score at 6 months and new clinical events after ICH are the major determinants.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Modified Rankin Scale
Risk Factors
Internal medicine
Diabetes mellitus
medicine
Dementia
Humans
In patient
Prospective Studies
Functional decline
Stroke
Aged
Cerebral Hemorrhage
Clinical events
business.industry
Age Factors
Recovery of Function
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Psychiatry and Mental health
Baseline characteristics
Surgery
Female
Neurology (clinical)
business
030217 neurology & neurosurgery
Follow-Up Studies
Subjects
Details
- ISSN :
- 1468330X
- Volume :
- 92
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Journal of neurology, neurosurgery, and psychiatry
- Accession number :
- edsair.doi.dedup.....113131d9081a0d7c0b92644d478e3ba0