Intracerebral hemorrhage location and outcome among INTERACT2 participants

Neurology. 2017 Apr 11;88(15):1408-1414. doi: 10.1212/WNL.0000000000003771. Epub 2017 Feb 24.

Abstract

Objective: To clarify associations between intracerebral hemorrhage (ICH) location and clinical outcomes among participants of the main phase Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2).

Methods: Associations between ICH sites and poor outcomes (death [6] or major disability [3-5] of modified Rankin Scale) and European Quality of Life Scale (EQ-5D) utility scores at 90 days were assessed in logistic regression models.

Results: Of 2,066 patients included in the analyses, associations were identified between ICH sites and poor outcomes: involvement of posterior limb of internal capsule increased risks of death or major disability (odds ratio [OR] 2.10) and disability (OR 1.81); thalamic involvement increased risks of death or major disability (OR 2.24) and death (OR 1.97). Involvement of the posterior limb of the internal capsule, thalamus, and infratentorial sites were each associated with poor EQ-5D utility score (≤0.7 [median]; OR 1.87, 2.14, and 2.81, respectively). Posterior limb of internal capsule involvement was strongly associated with low scores across all health-related quality of life domains. ICH encompassing the thalamus and posterior limb of internal capsule were associated with death or major disability, major disability, and poor EQ-5D utility score (OR 1.72, 2.26, and 1.71, respectively).

Conclusion: Poor clinical outcomes are related to ICH affecting the posterior limb of internal capsule, thalamus, and infratentorial sites. The highest association with death or major disability and poor EQ-5D utility score was seen in ICH encompassing the thalamus and posterior limb of internal capsule.

Clinicaltrialsgov registration: NCT00716079.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure / drug effects*
  • Blood Pressure / physiology*
  • Cerebral Hemorrhage / diagnostic imaging
  • Cerebral Hemorrhage / drug therapy*
  • Cerebral Hemorrhage / physiopathology*
  • Disability Evaluation
  • Disabled Persons
  • Female
  • Follow-Up Studies
  • Hematoma / drug therapy
  • Hematoma / etiology
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Quality of Life
  • Retrospective Studies
  • Single-Blind Method
  • Tomography Scanners, X-Ray Computed

Substances

  • Antihypertensive Agents

Associated data

  • ClinicalTrials.gov/NCT00716079