Association of large core middle cerebral artery stroke and hemorrhagic transformation with hospitalization outcomes.

Humans Female Male Aged Retrospective Studies Middle Aged Hospitalization Infarction, Middle Cerebral Artery / complications Cerebral Hemorrhage / etiology Brain Edema / etiology Risk Factors Ischemic Stroke / mortality

Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
01 05 2024
Historique:
received: 28 07 2023
accepted: 25 04 2024
medline: 2 5 2024
pubmed: 2 5 2024
entrez: 1 5 2024
Statut: epublish

Résumé

Historically, investigators have not differentiated between patients with and without hemorrhagic transformation (HT) in large core ischemic stroke at risk for life-threatening mass effect (LTME) from cerebral edema. Our objective was to determine whether LTME occurs faster in those with HT compared to those without. We conducted a two-center retrospective study of patients with ≥ 1/2 MCA territory infarct between 2006 and 2021. We tested the association of time-to-LTME and HT subtype (parenchymal, petechial) using Cox regression, controlling for age, mean arterial pressure, glucose, tissue plasminogen activator, mechanical thrombectomy, National Institute of Health Stroke Scale, antiplatelets, anticoagulation, temperature, and stroke side. Secondary and exploratory outcomes included mass effect-related death, all-cause death, disposition, and decompressive hemicraniectomy. Of 840 patients, 358 (42.6%) had no HT, 403 (48.0%) patients had petechial HT, and 79 (9.4%) patients had parenchymal HT. LTME occurred in 317 (37.7%) and 100 (11.9%) had mass effect-related deaths. Parenchymal (HR 8.24, 95% CI 5.46-12.42, p < 0.01) and petechial HT (HR 2.47, 95% CI 1.92-3.17, p < 0.01) were significantly associated with time-to-LTME and mass effect-related death. Understanding different risk factors and sequelae of mass effect with and without HT is critical for informed clinical decisions.

Identifiants

DOI: 10.1038/s41598-024-60635-0 PMID: 38693282
pubmed: 38693282
doi: 10.1038/s41598-024-60635-0
pii: 10.1038/s41598-024-60635-0
doi:

Types de publication

Journal Article Multicenter Study Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

10008

Subventions

Organisme : NIH HHS
ID : R01 EY024019
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL092577
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS102574
Pays : United States
Organisme : NINDS NIH HHS
ID : K23NS116033
Pays : United States

Informations de copyright

© 2024. The Author(s).

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Auteurs

Jack E Pohlmann (JE)

Department of Neurology, Boston Medical Center, 1 Boston Medical Center PI, Boston, MA, 02118, USA.
Department of Epidemiology, School of Public Health, Boston University, 715 Albany St, Boston, MA, 02118, USA.

Ivy So Yeon Kim (ISY)

Department of Neurology, Boston Medical Center, 1 Boston Medical Center PI, Boston, MA, 02118, USA.

Benjamin Brush (B)

Department of Neurology, NYU Langone Medical Center, 550 1st Ave, New York, NY, 10016, USA.

Krishna M Sambhu (KM)

Department of Neurology, Boston University School of Medicine, Chobanian and Avedisian School of Medicine, 85 E Concord St., Suite 1116, Boston, MA, 02118, USA.

Lucas Conti (L)

Department of Neurology, Boston University School of Medicine, Chobanian and Avedisian School of Medicine, 85 E Concord St., Suite 1116, Boston, MA, 02118, USA.

Hanife Saglam (H)

Department of Neurology, Brigham & Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.

Katie Milos (K)

Department of Neurology, Boston Medical Center, 1 Boston Medical Center PI, Boston, MA, 02118, USA.

Lillian Yu (L)

Department of Neurology, Boston Medical Center, 1 Boston Medical Center PI, Boston, MA, 02118, USA.

Michael F M Cronin (MFM)

Department of Neurology, Boston University School of Medicine, Chobanian and Avedisian School of Medicine, 85 E Concord St., Suite 1116, Boston, MA, 02118, USA.

Oluwafemi Balogun (O)

Department of Neurology, Boston Medical Center, 1 Boston Medical Center PI, Boston, MA, 02118, USA.

Stefanos Chatzidakis (S)

Department of Neurology, Brigham & Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.

Yihan Zhang (Y)

Department of Neurology, Boston Medical Center, 1 Boston Medical Center PI, Boston, MA, 02118, USA.

Ludovic Trinquart (L)

Department of Epidemiology, School of Public Health, Boston University, 715 Albany St, Boston, MA, 02118, USA.
Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington St, Boston, MA, 02111, USA.
Tufts Clinical and Translational Science Institute, Tufts University, 419 Boston, Ave, Medford, MA, 02155, USA.

Qiuxi Huang (Q)

Department of Epidemiology, School of Public Health, Boston University, 715 Albany St, Boston, MA, 02118, USA.

Stelios M Smirnakis (SM)

Department of Neurology, Brigham & Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.
Department of Neurology, Jamaica Plain Veterans Administration Medical Center, 150 S Huntington Ave, Boston, MA, 02130, USA.

Emelia J Benjamin (EJ)

Department of Epidemiology, School of Public Health, Boston University, 715 Albany St, Boston, MA, 02118, USA.
Department of Cardiology, Boston Medical Center and Boston University Chobanian and Avedisian School of Medicine, 85 E Concord St, Boston, MA, 02118, USA.

Josée Dupuis (J)

Department of Epidemiology, School of Public Health, Boston University, 715 Albany St, Boston, MA, 02118, USA.
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 2001 McGill College, Montreal, QC, Canada.

David M Greer (DM)

Department of Neurology, Boston Medical Center, 1 Boston Medical Center PI, Boston, MA, 02118, USA.
Department of Neurology, Boston University School of Medicine, Chobanian and Avedisian School of Medicine, 85 E Concord St., Suite 1116, Boston, MA, 02118, USA.

Charlene J Ong (CJ)

Department of Neurology, Boston Medical Center, 1 Boston Medical Center PI, Boston, MA, 02118, USA. cjong@bu.edu.
Department of Neurology, Boston University School of Medicine, Chobanian and Avedisian School of Medicine, 85 E Concord St., Suite 1116, Boston, MA, 02118, USA. cjong@bu.edu.
Department of Neurology, Brigham & Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA. cjong@bu.edu.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Association of large core middle cerebral...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Association of large core middle cerebral...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Association of large core middle cerebral...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Association of large core middle cerebral...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Soins aux patients › Hospitalisation › Association of large core middle cerebral...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Nécrose › Infarctus › Infarctus encéphalique › Infarctus cérébral › Infarctus du territoire de l'artère cérébrale moyenne › Association of large core middle cerebral...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Hémorragie › Hémorragies intracrâniennes › Hémorragie cérébrale › Association of large core middle cerebral...
questionsmedicales.fr › Maladies du système nerveux › Maladies du système nerveux central › Encéphalopathies › Oedème cérébral › Association of large core middle cerebral...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Risque › Facteurs de risque › Association of large core middle cerebral...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Accident vasculaire cérébral › Accident vasculaire cérébral ischémique › Association of large core middle cerebral...