Baseline factors associated with early and late death in intracerebral haemorrhage survivors

Banerjee, G. et al. (2020) Baseline factors associated with early and late death in intracerebral haemorrhage survivors. European Journal of Neurology, 27(7), pp. 1257-1263. (doi: 10.1111/ene.14238) (PMID:32223078)

Abstract

Background and purpose: The aim of this study was to determine whether early and late death are associated with different baseline factors in intracerebral haemorrhage (ICH) survivors. Methods: This was a secondary analysis of the multicentre prospective observational CROMIS‐2 ICH study. Death was defined as ‘early’ if occurring within 6 months of study entry and ‘late’ if occurring after this time point. Results: In our cohort (n = 1094), there were 306 deaths (per 100 patient‐years: absolute event rate, 11.7; 95% confidence intervals, 10.5–13.1); 156 were ‘early’ and 150 ‘late’. In multivariable analyses, early death was independently associated with age [per year increase; hazard ratio (HR), 1.05, P = 0.003], history of hypertension (HR, 1.89, P = 0.038), pre‐event modified Rankin scale score (per point increase; HR, 1.41, P < 0.0001), admission National Institutes of Health Stroke Scale score (per point increase; HR, 1.11, P < 0.0001) and haemorrhage volume >60 mL (HR, 4.08, P < 0.0001). Late death showed independent associations with age (per year increase; HR, 1.04, P = 0.003), pre‐event modified Rankin scale score (per point increase; HR, 1.42, P = 0.001), prior anticoagulant use (HR, 2.13, P = 0.028) and the presence of intraventricular extension (HR, 1.73, P = 0.033) in multivariable analyses. In further analyses where time was treated as continuous (rather than dichotomized), the HR of previous cerebral ischaemic events increased with time, whereas HRs for Glasgow Coma Scale score, National Institutes of Health Stroke Scale score and ICH volume decreased over time. Conclusions: We provide new evidence that not all baseline factors associated with early mortality after ICH are associated with mortality after 6 months and that the effects of baseline variables change over time. Our findings could help design better prognostic scores for later death after ICH.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Muir, Professor Keith
• Authors: Banerjee, G., Ambler, G., Wilson, D., Hostettler, I. C., Shakeshaft, C., Lunawat, S., Cohen, H., Yousry, T., Al-Shahi Salman, R., Lip, G. Y.H., Houlden, H., Muir, K. W., Brown, M. M., Jäger, H. R., and Werring, D. J.
• College/School: College of Medical Veterinary and Life Sciences > School of Psychology & Neuroscience
• Journal Name: European Journal of Neurology
• Publisher: Wiley
• ISSN: 1351-5101
• ISSN (Online): 1468-1331
• Published Online: 29 March 2020
• Copyright Holders: Copyright © 2020 The Authors
• First Published: First published in European Journal of Neurology 27(7): 1257-1263
• Publisher Policy: Reproduced under a Creative Commons License