2023-01-28
Extension of hemorrhage into the subarachnoid space (SAHE) is sometimes observed simultaneously in primary ICH. Previous studies have found that SAHE is associated with poor outcomes in primary ICH patients and hematoma expansion in lobar ICH. The mechanism is unclear. Our study aims to investigate whether SAHE is independently associated with poor outcomes in patients with supratentorial ICH.
Our study is a retrospective analysis using data from the prospective, multicenter, observational, registry-based study in Beijing, China. The inclusion criteria are listed as follows: (1) Supratentorial ICH was diagnosed by the WHO standard and confirmed by each hospital’s computerized tomography (CT) scan; (2) with the age ≥18 years old; (3) arriving at emergency and performed CT scan within 72 hours after symptoms onset; (4) written consent was obtained. The exclusion criteria include the following: (1) known major comorbidities or late-stage diseases, such as liver failure, end-stage kidney diseases, heart failure and malignant tumor; (2) first-ever acute-onset ICH; (3) congenital or obtained coagulation disorders confirmed by imaging or laboratory tests (4) severe missing of follow-up outcomes. First, we will describe and compare baseline characteristics between two groups with and without SAHE. Second, we will compare the prognosis such as death and mRS between two groups. Finally, the regression model will be built to determine the association between baseline SAHE and poor outcomes at discharge, 1 month, 3 months and 1 year.
SAHE is independently associated with poor outcomes in patients with supratentorial ICH. It may provide a promising target for developing new predictive tools targeting ICH
A total of 931 patients were included in this study (SAHE vs. no SAHE, 121 [13.0%] vs. 810 [87.0%]). Patients with SAHE had more severe neurological defcits, higher scores of the mRS, and more remarkable mortality rates at follow-up (all p values<0.05). In multivariable-adjusted models, SAHE was independently associated with a higher risk of poor outcomes (adjusted OR [95%CI]: 2.030 [1.142–3.608] at 3 months; 2.348 [1.337–4.123] at 1 year). In addition, SAHE remained an independent association with an increased death rate at 1 year (adjusted HR [95%CI], 1.314[1.057–1.635]). In the subgroup analysis, the correlation between SAHE and prognosis exists in patients with lobar or deep ICH.