Review ArticleLeukoaraiosis is Associated with Short- and Long-term Mortality in Patients with Intracerebral Hemorrhage
Section snippets
Patients
The study includes all consecutive patients hospitalized with a first-ever ICH between 2005 and 2009 at Sørlandet Hospital Kristiansand in Kristiansand, Norway. The hospital serves a well-defined catchment area with 152,000 inhabitants. There is a low-threshold policy of admitting all patients with suspected stroke to the neurologic department regardless of age and stroke severity. There is no neurosurgical department. All patients with suspected stroke are examined in the emergency room by the
Results
In total, 134 patients with a first-ever ICH were followed up for a median of 4.7 years (interquartile range 2.5-6.6 years), for a total of 630 patient-years. No patients were lost to follow-up. Baseline characteristics are shown in total and for each sex in Table 1. There were some sex differences in baseline characteristics. Men were significantly younger, were more often smokers, and had somewhat larger hematomas than women. White patients accounted for 131 of 134 (97.8%) cases. Five
Discussion
This study shows that leukoaraiosis is associated with both 30-day and long-term mortality in patients with first-ever ICH. It also shows that CHD is associated with increased long-term mortality.
The overall mortality at standardized time points is in general agreement with previous reports.5, 8, 13, 27, 28, 29 With volumes exceeding 30 mL, all hematoma locations other than lobar carried a high 30-day mortality rate (Table 2). Smaller cerebellar hematomas had the lowest mortality rates. This is
Acknowledgment
We thank Siv Pettersen and Karen Johanne Olsen for their assistance with data collection and statistician Hugo Pripp, PhD, for assistance with statistical analysis.
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2020, Journal of Stroke and Cerebrovascular DiseasesCitation Excerpt :Recent studies have suggested that the total small vessel disease (SVD) score, which integrates all individual SVD markers, may better represent the total brain burden than a single marker.1 In patients after intracerebral hemorrhage (ICH), each SVD marker is an independent predictor for poor prognosis2–4; however, few studies have examined the association between functional disabilities and the global SVD burden.4 We hypothesized that the likelihood of worse functional outcomes following ICH might vary with the underlying SVD burden.
Progression of White Matter Injury After Intracerebral Hemorrhage: A Magnetic Resonance Imaging Study
2019, World NeurosurgeryCitation Excerpt :Several studies have previously examined the association between the extent of WMI and outcomes for patients with ICH.4-6 They found that the severity of WMI on the baseline scan was associated with worse functional outcomes or mortality after spontaneous ICH.4-6 We found no difference in the baseline severity of WMI between patients with versus without WMIP, and the severity of WMI on the baseline MRI scan was not associated with unfavorable 90-day outcomes in our study.
Prognostic significance of leukoaraiosis in intracerebral hemorrhage: A meta-analysis
2019, Journal of the Neurological SciencesPredictors of long-term survival after spontaneous intracerebral hemorrhage in southern Portugal: A retrospective study of a community representative population
2018, Journal of the Neurological SciencesCitation Excerpt :Nevertheless, increasing age is consistently shown to aggravate SICH long-term prognosis [2,3], possibly due to the cumulative burden of coexistent comorbidities or underlying chronic generalized vascular disease [3,23]. The main causes of long-term death after SICH vary between studies, but infections with pneumonia ahead, recurrent stroke and cardiovascular complications are commonly reported [15,22]. Better adherence to preventive strategies, control of blood pressure, mobilization, healthy life style are among the interventions that may reduce these complications.
Response to Commentary on “Short-Term Outcome of Spontaneous Intracerebral Hemorrhage in Algarve, Portugal: Retrospective Hospital-Based Study”
2018, Journal of Stroke and Cerebrovascular Diseases
Dr. Tveiten is supported by the Norwegian Health Association.