Longer term stroke risk in intracerebral haemorrhage survivors. Issue 8 (17th June 2020)

• Record Type: Journal Article
• Authors: Banerjee, Gargi; Wilson, Duncan; Ambler, Gareth; Hostettler, Isabel Charlotte; Shakeshaft, Clare; Cohen, Hannah; Yousry, Tarek; Al-Shahi Salman, Rustam; Lip, Gregory Y H; Houlden, Henry; Muir, Keith W; Brown, Martin M; Jäger, Hans Rolf; Werring, David J
• Other Names: author non-byline.; Shaw Louise author non-byline.; Harkness Kirsty author non-byline.; Sword Jane author non-byline.; MohdNor Azlisham author non-byline.; Sharma Pankaj author non-byline.; Kelly Deborah author non-byline.; Harrington Frances author non-byline.; Randall Marc author non-byline.; Smith Matthew author non-byline.; Mahawish Karim author non-byline.; Elmarim Abduelbaset author non-byline.; Esisi Bernard author non-byline.; Cullen Claire author non-byline.; Nallasivam Arumug author non-byline.; Price Christopher author non-byline.; Barry Adrian author non-byline.; Roffe Christine author non-byline.; Coyle John author non-byline.; Hassan Ahamad author non-byline.; Lovelock Caroline author non-byline.; Birns Jonathan author non-byline.; Cohen David author non-byline.; Sekaran L author non-byline.; Parry-Jones Adrian author non-byline.; Parry Anthea author non-byline.; Hargroves David author non-byline.; Proschel Harald author non-byline.; Datta Prabel author non-byline.; Darawil Khaled author non-byline.; Manoj Aravindakshan author non-byline.; Burn Mathew author non-byline.; Patterson Chris author non-byline.; Giallombardo Elio author non-byline.; Smyth Nigel author non-byline.; Mansoor Syed author non-byline.; Anwar Ijaz author non-byline.; Marsh Rachel author non-byline.; Ispoglou Sissi author non-byline.; Chadha Dinesh author non-byline.; Prabhakaran Mathuri author non-byline.; Meenakishundaram Sanjeevikumar author non-byline.; O'Connell Janice author non-byline.; Scott Jon author non-byline.; Krishnamurthy Vinodh author non-byline.; Aghoram Prasanna author non-byline.; McCormick Michael author non-byline.; O'Mahony Paul author non-byline.; Cooper Martin author non-byline.; Choy Lillian author non-byline.; Wilkinson Peter author non-byline.; Leach Simon author non-byline.; Caine Sarah author non-byline.; Burger Ilse author non-byline.; Gunathilagan Gunaratam author non-byline.; Guyler Paul author non-byline.; Emsley Hedley author non-byline.; Davis Michelle author non-byline.; Manawadu Dulka author non-byline.; Pasco Kath author non-byline.; Mamun Maam author non-byline.; Luder Robert author non-byline.; Sajid Mahmud author non-byline.; Anwar Ijaz author non-byline.; Okwera James author non-byline.; Staals Julie author non-byline.; Warburton Elizabeth author non-byline.; Saastamoinen Kari author non-byline.; England Timothy author non-byline.; Putterill Janet author non-byline.; Flossman Enrico author non-byline.; Power Michael author non-byline.; Dani Krishna author non-byline.; Mangion David author non-byline.; Suman Appu author non-byline.; Corrigan John author non-byline.; Lawrence Enas author non-byline.; Vahidassr Djamil author non-byline.;
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 91:Issue 8(2020)
• Page Start: 840
• Page End: 845
• Publication Date: 2020-06-17
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2020-323079
• Languages: English
• ISSNs: 0022-3050

Abstract

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 .