Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology and the National Hospital for Neurology and Neurosurgery, London, United Kingdom.
Department of Statistical Science, University College London, London, United Kingdom.
J Neurol Neurosurg Psychiatry. 2020 Aug;91(8):840-845. doi: 10.1136/jnnp-2020-323079. Epub 2020 Jun 17.
To evaluate the influence of intracerebral haemorrhage (ICH) location on stroke outcomes.
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.
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.
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.
NCT02513316.
评估颅内出血（ICH）部位对卒中结局的影响。
我们纳入了一项英国医院多中心观察性研究中的患者，该研究对象为影像学证实的自发性 ICH 成人患者。主要结局为研究入组后发生脑缺血事件（卒中或短暂性脑缺血发作）或再次发生 ICH。血肿部位分为脑叶或非脑叶。
共纳入了 CROMIS-2（卒中微出血的临床意义）ICH 研究的 1094 例患者（平均年龄 73.3 岁；57.4%为男性）。共发生 45 例复发性 ICH 事件（绝对事件发生率（AER）为每 100 患者年 1.88 例）；447 例脑叶 ICH 患者中发生 35 例（AER 为每 100 患者年 3.77 例）；580 例非脑叶 ICH 患者中发生 9 例（AER 为每 100 患者年 0.69 例）。多变量 Cox 回归发现，脑叶 ICH 与 ICH 复发相关（HR 8.96，95%CI 3.36 至 23.87，p<0.0001）；在多变量完成风险分析中也得到了类似的结果。共发生 70 例脑缺血事件（AER 为每 100 患者年 2.93 例）；447 例脑叶 ICH 患者中发生 29 例（AER 为每 100 患者年 3.12 例）；580 例非脑叶 ICH 患者中发生 39 例（AER 为每 100 患者年 2.97 例）。多变量 Cox 回归未发现 ICH 部位与事件相关（HR 1.13，95%CI 0.66 至 1.92，p 0.659）。在完成风险分析中也得到了类似的结果。
在 ICH 幸存者中，脑叶 ICH 部位与复发性 ICH 事件风险高于非脑叶 ICH 部位相关；ICH 部位不影响随后发生缺血性事件的风险。
NCT02513316。
