Functional outcome improvement from 3 to 12 months after intracerebral hemorrhage
INTRODUCTION: Most intracerebral hemorrhage (ICH) trials assessed outcome at 3 months but the recovery trajectory of ICH survivors may continue up to 1 year after the index event. We aimed to describe the predictors of functional outcome improvement from 3 to 12 months after ICH.
MATERIALS AND METHODS: Retrospective analysis of patients admitted to six European Stroke Centers for supratentorial ICH. Functional outcome was measured with the modified Rankin Scale (mRS) at 3 and 12 months. Predictors of functional outcome improvement were explored with binary logistic regression.
RESULTS: We included 703 patients, of whom 245 (34.9%) died within 3 months. Among survivors, 131 (28.6%) had an mRS improvement, 78 (17.0%) had a worse mRS and 249 (54.4%) had a stable functional status at 12 months. Older age and the presence of baseline disability (defined as pre-stroke mRS > 1), were associated with lower odds of functional outcome improvement (Odds Ratio (OR) 0.98 per year increase, 95% Confidence Interval (CI) 0.96-1.00, p = 0.017 and OR 0.45, 95% CI 0.25-0.81, p = 0.008 respectively). Conversely, deep ICH location increased the probability of long term mRS improvement (OR 1.67, 95% CI, 1.07-2.61, p = 0.023). Patients with mild-moderate disability at 3 months (mRS 2-3) had the highest odds of improvement at 12 months (OR 8.76, 95% CI 3.68-20.86, p < 0.001).
DISCUSSION AND CONCLUSION: Long term recovery is common after ICH and associated with age, baseline functional status, mRS at 3 months and hematoma location. Our findings might inform future trials and improve long-term prognostication in clinical practice.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
European stroke journal - (2024) vom: 06. Jan., Seite 23969873231222782 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Morotti, Andrea [VerfasserIn] |
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| Links: |
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| Themen: |
Improvement |
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| Anmerkungen: |
Date Revised 06.01.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1177/23969873231222782 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM366738984 |
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| 245 | 1 | 0 | |a Functional outcome improvement from 3 to 12 months after intracerebral hemorrhage |
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| 520 | |a INTRODUCTION: Most intracerebral hemorrhage (ICH) trials assessed outcome at 3 months but the recovery trajectory of ICH survivors may continue up to 1 year after the index event. We aimed to describe the predictors of functional outcome improvement from 3 to 12 months after ICH | ||
| 520 | |a MATERIALS AND METHODS: Retrospective analysis of patients admitted to six European Stroke Centers for supratentorial ICH. Functional outcome was measured with the modified Rankin Scale (mRS) at 3 and 12 months. Predictors of functional outcome improvement were explored with binary logistic regression | ||
| 520 | |a RESULTS: We included 703 patients, of whom 245 (34.9%) died within 3 months. Among survivors, 131 (28.6%) had an mRS improvement, 78 (17.0%) had a worse mRS and 249 (54.4%) had a stable functional status at 12 months. Older age and the presence of baseline disability (defined as pre-stroke mRS > 1), were associated with lower odds of functional outcome improvement (Odds Ratio (OR) 0.98 per year increase, 95% Confidence Interval (CI) 0.96-1.00, p = 0.017 and OR 0.45, 95% CI 0.25-0.81, p = 0.008 respectively). Conversely, deep ICH location increased the probability of long term mRS improvement (OR 1.67, 95% CI, 1.07-2.61, p = 0.023). Patients with mild-moderate disability at 3 months (mRS 2-3) had the highest odds of improvement at 12 months (OR 8.76, 95% CI 3.68-20.86, p < 0.001) | ||
| 520 | |a DISCUSSION AND CONCLUSION: Long term recovery is common after ICH and associated with age, baseline functional status, mRS at 3 months and hematoma location. Our findings might inform future trials and improve long-term prognostication in clinical practice | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Intracerebral hemorrhage | |
| 650 | 4 | |a improvement | |
| 650 | 4 | |a modified Rankin Scale | |
| 650 | 4 | |a outcome | |
| 650 | 4 | |a recovery | |
| 700 | 1 | |a Nawabi, Jawed |e verfasserin |4 aut | |
| 700 | 1 | |a Pilotto, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Toffali, Maddalena |e verfasserin |4 aut | |
| 700 | 1 | |a Busto, Giorgio |e verfasserin |4 aut | |
| 700 | 1 | |a Mazzacane, Federico |e verfasserin |4 aut | |
| 700 | 1 | |a Cavallini, Anna |e verfasserin |4 aut | |
| 700 | 1 | |a Laudisi, Michele |e verfasserin |4 aut | |
| 700 | 1 | |a Gentile, Luana |e verfasserin |4 aut | |
| 700 | 1 | |a Viola, Maria Maddalena |e verfasserin |4 aut | |
| 700 | 1 | |a Schlunk, Frieder |e verfasserin |4 aut | |
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| 700 | 1 | |a Zini, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Padovani, Alessandro |e verfasserin |4 aut | |
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