Predictors of hematoma volume in deep and lobar supratentorial intracerebral hemorrhage.
Predictors of hematoma volume in deep and lobar supratentorial intracerebral hemorrhage.
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DOI：
10.1001/jamaneurol.2013.98
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发表时间：
2013-08
期刊：
影响因子：
29
通讯作者：
Rosand, Jonathan
中科院分区：
文献类型：
--
作者：
Falcone, Guido J.;Biffi, Alessandro;Brouwers, H. Bart;Anderson, Christopher D.;Battey, Thomas W. K.;Ayres, Alison M.;Vashkevich, Anastasia;Schwab, Kristin;Rost, Natalia S.;Goldstein, Joshua N.;Viswanathan, Anand;Greenberg, Steven M.;Rosand, Jonathan
血肿体积是脑出血（ICH）预后的最强预测因子。尽管已知深部和大叶性颅内血肿之间的潜在生物学差异，但报告影响血肿体积的因素的位置特异性的数据有限。为了评估脑出血体积的决定因素是否因地形而异，我们试图估计该放射学结果的潜在预测因子的位置特异性效应。前瞻性队列研究。学术医疗中心。2000年1月1日至2010年12月31日期间，共纳入744例幕上原发性ICH患者（388例深部和356例脑叶），年龄大于18岁。在急诊科就诊时通过计算机断层扫描测量的脑出血量。进行线性回归分析，按ICH位置分层，以确定对数转换的ICH体积的决定因素。脑叶血肿的中位ICH体积（39 mL;四分位距，16-75 mL）大于深部血肿（13 mL;四分位距，5-40 mL; P<.001）。在多变量线性回归中，深部ICH体积的独立预测因子是抗凝强度（β=0.32;标准误[SE]=0.08; P<0.001; 4类国际标准化比值趋势检验），冠状动脉疾病史（β=0.33; SE=0.17; P= 0.05）、男性（β=0.28; SE=0.14; P= 0.05）和年龄（β=-0.02; SE=0.01; P= 0.001）。脑叶ICH体积的独立预测因素是抗凝强度（β=0.14; SE=0.06; P= 0.02）和抗血小板治疗（β=0.27; SE=0.13; P= 0.03）。血肿体积的预测因素在深部和脑叶ICH之间仅部分重叠。这些发现表明，决定出血程度的机制在深部和大叶性颅内出血中是不同的。需要进一步的研究来表征所观察到的关联背后的特定生物学途径。
Hematoma volume is the strongest predictor of outcome in intracerebral hemorrhage (ICH). Despite known differences in the underlying biology between deep and lobar ICHs, limited data are available on location specificity of factors reported to affect hematoma volume. To evaluate whether determinants of ICH volume differ by topography, we sought to estimate location-specific effects for potential predictors of this radiological outcome. Prospective cohort study. Academic medical center. A total of 744 supratentorial primary ICH patients (388 deep and 356 lobar) aged older than 18 years admitted between January 1, 2000, and December 31, 2010. Intracerebral hemorrhage volume measured from the computed tomography scan obtained on presentation to the emergency department. Linear regression analysis, stratified by ICH location, was implemented to identify determinants of log-transformed ICH volume. Median ICH volume was larger in lobar hemorrhages (39 mL; interquartile range, 16-75 mL) than in deep hemorrhages (13 mL; interquartile range, 5-40 mL; P<.001). In multivariable linear regression, independent predictors of deep ICH volume were intensity of anticoagulation (β=0.32; standard error [SE]=0.08; P<.001; test for trend across 4 categories of the international normalized ratio), history of coronary artery disease (β=0.33; SE=0.17; P=.05), male sex (β=0.28; SE=0.14; P=.05), and age (β=−0.02; SE=0.01; P=.001). Independent predictors of lobar ICH volume were intensity of anticoagulation (β=0.14; SE=0.06; P=.02) and antiplatelet treatment (β=0.27; SE=0.13; P=.03). Predictors of hematoma volume only partially overlap between deep and lobar ICHs. These findings suggest that the mechanisms that determine the extent of bleeding differ for deep and lobar ICHs. Further studies are needed to characterize the specific biological pathways that underlie the observed associations.
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影响因子：
5
作者：
Wojcik, Nancy C.;Huebner, Wendy W.;Jorgensen, Gail
通讯作者：
Jorgensen, Gail
影响因子：
158.5
作者：
Mayer, Stephan A.;Brun, Nikolai C.;Steiner, Thorsten
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Steiner, Thorsten
影响因子：
9.9
作者：
Goldstein, J. N.;Fazen, L. E.;Rosand, J.
通讯作者：
Rosand, J.
DOI：
10.1016/s1474-4422(12)70104-7
发表时间：
2012-08
期刊：
The Lancet. Neurology
影响因子：
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作者：
Keep RF;Hua Y;Xi G
通讯作者：
Xi G
影响因子：
4.1
作者：
ZIDAN, AH;GIRVIN, JP
通讯作者：
GIRVIN, JP