Total small vessel disease score and functional outcomes following acute intracerebral hemorrhage.


Journal

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
ISSN: 1532-8511
Titre abrégé: J Stroke Cerebrovasc Dis
Pays: United States
ID NLM: 9111633

Informations de publication

Date de publication:
Aug 2020
Historique:
received: 20 01 2020
revised: 21 05 2020
accepted: 25 05 2020
entrez: 22 7 2020
pubmed: 22 7 2020
medline: 24 10 2020
Statut: ppublish

Résumé

Individual cerebral small vessel disease (SVD) markers are independent predictors for poor prognosis following intracerebral hemorrhage (ICH), however, the impact of the cumulative SVD burden on outcomes remains unclear. We aimed to investigate the association between the global SVD burden and functional outcomes following ICH. We retrospectively evaluated a consecutive cohort of patients with ICH who underwent brain magnetic resonance imaging and magnetic resonance angiography, from a prospective registry. We identified the presence and severity of the SVD markers (cerebral microbleeds, lacunar infarctions, periventricular hyperintensities, and deep white matter hyperintensities) and summed them to obtain the modified total SVD score (0-4). Poor functional outcomes were defined as a modified Rankin Scale score at discharge ≥ 3. A multivariate logistic regression model was used to assess the association between patient outcomes and the SVD score. A total of 144 patients were included (65.0 ± 12.2 years, 67.4% male). The modified total SVD score was potentially associated with poor functional outcomes (odds ratio [OR] 1.72, 95% confidence interval [CI] 0.97-3.03) after adjustment for age, sex, history of stroke, chronic kidney disease, prior use of antithrombotic agents, the National Institutes of Health Stroke Scale score on admission, the non-lobar location of ICH, and hematoma volume on admission. Moreover, among older patients (≥ 65 years), the SVD score was associated with poor outcomes (OR 3.11, 95% CI 1.01-9.55). Among those with supratentorial ICH, the score remained significant (OR 2.06, 95% CI 1.11-3.83). The modified total SVD score may have predictive value for poor functional outcomes following ICH.

Sections du résumé

BACKGROUND BACKGROUND
Individual cerebral small vessel disease (SVD) markers are independent predictors for poor prognosis following intracerebral hemorrhage (ICH), however, the impact of the cumulative SVD burden on outcomes remains unclear. We aimed to investigate the association between the global SVD burden and functional outcomes following ICH.
METHODS METHODS
We retrospectively evaluated a consecutive cohort of patients with ICH who underwent brain magnetic resonance imaging and magnetic resonance angiography, from a prospective registry. We identified the presence and severity of the SVD markers (cerebral microbleeds, lacunar infarctions, periventricular hyperintensities, and deep white matter hyperintensities) and summed them to obtain the modified total SVD score (0-4). Poor functional outcomes were defined as a modified Rankin Scale score at discharge ≥ 3. A multivariate logistic regression model was used to assess the association between patient outcomes and the SVD score.
RESULTS RESULTS
A total of 144 patients were included (65.0 ± 12.2 years, 67.4% male). The modified total SVD score was potentially associated with poor functional outcomes (odds ratio [OR] 1.72, 95% confidence interval [CI] 0.97-3.03) after adjustment for age, sex, history of stroke, chronic kidney disease, prior use of antithrombotic agents, the National Institutes of Health Stroke Scale score on admission, the non-lobar location of ICH, and hematoma volume on admission. Moreover, among older patients (≥ 65 years), the SVD score was associated with poor outcomes (OR 3.11, 95% CI 1.01-9.55). Among those with supratentorial ICH, the score remained significant (OR 2.06, 95% CI 1.11-3.83).
CONCLUSIONS CONCLUSIONS
The modified total SVD score may have predictive value for poor functional outcomes following ICH.

Identifiants

pubmed: 32689644
pii: S1052-3057(20)30419-5
doi: 10.1016/j.jstrokecerebrovasdis.2020.105001
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

105001

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None.

Auteurs

Yoko Kimura (Y)

Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan. Electronic address: yokokimura@neurol.med.osaka-u.ac.jp.

Kaori Miwa (K)

Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita, Osaka, Japan. Electronic address: miwa@osaka-njm.net.

Junji Takasugi (J)

Department of Stroke Medicine, Japan Community Health care Organization Hoshigaoka Medical Center, Osaka, Japan. Electronic address: takasugi@neurol.med.osaka-u.ac.jp.

Naoki Oyama (N)

Department of Stroke Medicine, Kawasaki Medical School, Okayama, Japan. Electronic address: oyama@med.kawasaki-m.ac.jp.

Kenichi Todo (K)

Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan. Electronic address: ktodo@neurol.med.osaka-u.ac.jp.

Manabu Sakaguchi (M)

Department of Neurology, Osaka General Medical Center, Osaka, Japan. Electronic address: sakaguti@neurol.med.osaka-u.ac.jp.

Hideki Mochizuki (H)

Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan. Electronic address: hmochizuki@neurol.med.osaka-u.ac.jp.

Tsutomu Sasaki (T)

Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan. Electronic address: sasaki@neurol.med.osaka-u.ac.jp.

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