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- Title
Long-term mortality in survivors of spontaneous intracerebral hemorrhage.
- Authors
Pasi, Marco; Casolla, Barbara; Kyheng, Maéva; Boulouis, Grégoire; Kuchcinski, Grégory; Moulin, Solène; Labreuche, Julien; Hénon, Hilde; Cordonnier, Charlotte; Leys, Didier
- Abstract
Background: Factors associated with long-term mortality after spontaneous intracerebral hemorrhage (ICH) have been poorly investigated. Aim: Our objective was to identify variables associated with long-term mortality in a prospective cohort of 30-day ICH survivors. Methods: We prospectively included consecutive 30-day spontaneous ICH survivors. We evaluated baseline and follow-up clinical characteristics and magnetic resonance imaging (MRI) markers of chronic brain injury as variables associated with long-term mortality using univariate and multivariable Cox proportional hazard regression models. Results: Of 560 patients with spontaneous ICH, 304 (54.2%) survived more than 30 days and consented for follow-up. During a median follow-up of 10 years (interquartile range: 8.0–10.5), 176 patients died. The cumulative survival rate at 10 years was 38%. In multivariable analysis, variables independently associated with long-term mortality were age (hazard ratio (HR) per 10-year increase: 1.68, 95% confidence interval (CI): 1.45–1.95), male gender (HR: 1.41, CI: 1.02–1.95), prestroke dependency (HR: 1.66, CI: 1.15–2.39), National Institutes of Health Stroke Scale score (HR per 1-point increase: 1.03, CI: 1.01–1.04), occurrence of any stroke (HR: 2.24, CI: 1.39–3.60), and dementia (HR: 1.51, CI: 1.06–2.16) during follow-up. Among MRI markers, only cerebral atrophy (HR per 1-point increase: 1.50, CI: 1.13–2.00) was independently associated with long-term mortality. Conclusions: Preexisting comorbidities, clinical severity at presentation, and significant clinical event during follow-up are associated with long-term mortality. Among MRI markers of chronic brain injury, only cerebral atrophy is associated with long-term mortality.
- Subjects
NATIONAL Institutes of Health (U.S.); INTRACEREBRAL hematoma; SURVIVAL rate; STROKE; MAGNETIC resonance imaging; CEREBRAL hemorrhage; CEREBRAL atrophy; PROPORTIONAL hazards models
- Publication
International Journal of Stroke, 2021, Vol 16, Issue 4, p448
- ISSN
1747-4930
- Publication type
Article
- DOI
10.1177/1747493020954946