Predictors of the Intracerebral Hemorrhage Volume in Hypertensive Patients
Background: Hemorrhage volume is an important predictor of outcome in patients with intracerebral hemorrhage (ICH). It is not clear why in some patients ICH volume is larger than in others. Identification of modifiable factors responsible for large-volume hemorrhage in hypertensive patients may help...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Karger Publishers
2010-12-01
|
| Series: | Cerebrovascular Diseases Extra |
| Subjects: | |
| Online Access: | http://www.karger.com/Article/FullText/323270 |
| _version_ | 1828523114552623104 |
|---|---|
| author | Mohammad Wasay Adnan Yousuf Darshan Lal Safia Awan |
| author_facet | Mohammad Wasay Adnan Yousuf Darshan Lal Safia Awan |
| author_sort | Mohammad Wasay |
| collection | DOAJ |
| description | Background: Hemorrhage volume is an important predictor of outcome in patients with intracerebral hemorrhage (ICH). It is not clear why in some patients ICH volume is larger than in others. Identification of modifiable factors responsible for large-volume hemorrhage in hypertensive patients may help to reduce ICH-related morbidity and mortality. Objective: The objective of this study was to identify predictors of large-volume ICH in hypertensive patients. Methods: At a tertiary care center in Karachi (Pakistan), 157 hypertensive patients with ICH were prospectively analyzed in 2008–2009, and hemorrhage volumes were determined using CT or MRI and various factors, including duration of hypertension, medical treatment, compliance, co-morbidity, and hematologic and coagulation profiles. Logistic regression analysis was used to identify predictors of high-volume hemorrhage. A volume >30 mm3 was defined as high-volume hemorrhage. Results: Of 157 patients with hypertensive ICH evaluated, 133 patients were included in the study, and 24 patients with brain stem, cerebellum and pure intraventricular hemorrhage were excluded. The mean age of the study patients was 55 years; 56 patients (70%) were male. High-volume hemorrhage (>30 mm3) was noted in 47 (35%) patients. Mortality was significantly increased in patients with high-volume ICH (32 vs. 6% in patients with low-volume ICH). In univariate analysis, factors significantly associated with large-volume ICH were male gender (p = 0.002), hypertension lasting >10 years (p = 0.03), warfarin treatment (p = 0.05), use of >1 anti-hypertensive agent (p = 0.001) and poor compliance with medication (p = 0.001). In multivariate analysis, use of >1 anti-hypertensive agent and poor compliance were also predictors of large-volume ICH. Conclusion: High-volume hemorrhage was less common (28%) in our patients with hypertension and ICH. Use of >1 anti-hypertensive agent and poor compliance were predictors of large-volume ICH. |
| first_indexed | 2024-12-11T20:21:40Z |
| format | Article |
| id | doaj.art-2cc10a3de52f4e6398aa4f681b450722 |
| institution | Directory Open Access Journal |
| issn | 1664-5456 |
| language | English |
| last_indexed | 2024-12-11T20:21:40Z |
| publishDate | 2010-12-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Cerebrovascular Diseases Extra |
| spelling | doaj.art-2cc10a3de52f4e6398aa4f681b4507222022-12-22T00:52:03ZengKarger PublishersCerebrovascular Diseases Extra1664-54562010-12-01111510.1159/000323270323270Predictors of the Intracerebral Hemorrhage Volume in Hypertensive PatientsMohammad WasayAdnan YousufDarshan LalSafia AwanBackground: Hemorrhage volume is an important predictor of outcome in patients with intracerebral hemorrhage (ICH). It is not clear why in some patients ICH volume is larger than in others. Identification of modifiable factors responsible for large-volume hemorrhage in hypertensive patients may help to reduce ICH-related morbidity and mortality. Objective: The objective of this study was to identify predictors of large-volume ICH in hypertensive patients. Methods: At a tertiary care center in Karachi (Pakistan), 157 hypertensive patients with ICH were prospectively analyzed in 2008–2009, and hemorrhage volumes were determined using CT or MRI and various factors, including duration of hypertension, medical treatment, compliance, co-morbidity, and hematologic and coagulation profiles. Logistic regression analysis was used to identify predictors of high-volume hemorrhage. A volume >30 mm3 was defined as high-volume hemorrhage. Results: Of 157 patients with hypertensive ICH evaluated, 133 patients were included in the study, and 24 patients with brain stem, cerebellum and pure intraventricular hemorrhage were excluded. The mean age of the study patients was 55 years; 56 patients (70%) were male. High-volume hemorrhage (>30 mm3) was noted in 47 (35%) patients. Mortality was significantly increased in patients with high-volume ICH (32 vs. 6% in patients with low-volume ICH). In univariate analysis, factors significantly associated with large-volume ICH were male gender (p = 0.002), hypertension lasting >10 years (p = 0.03), warfarin treatment (p = 0.05), use of >1 anti-hypertensive agent (p = 0.001) and poor compliance with medication (p = 0.001). In multivariate analysis, use of >1 anti-hypertensive agent and poor compliance were also predictors of large-volume ICH. Conclusion: High-volume hemorrhage was less common (28%) in our patients with hypertension and ICH. Use of >1 anti-hypertensive agent and poor compliance were predictors of large-volume ICH.http://www.karger.com/Article/FullText/323270Brain hemorrhageCoagulation profileHemorrhage volumeHypertensionIntracerebral hemorrhageWarfarin |
| spellingShingle | Mohammad Wasay Adnan Yousuf Darshan Lal Safia Awan Predictors of the Intracerebral Hemorrhage Volume in Hypertensive Patients Cerebrovascular Diseases Extra Brain hemorrhage Coagulation profile Hemorrhage volume Hypertension Intracerebral hemorrhage Warfarin |
| title | Predictors of the Intracerebral Hemorrhage Volume in Hypertensive Patients |
| title_full | Predictors of the Intracerebral Hemorrhage Volume in Hypertensive Patients |
| title_fullStr | Predictors of the Intracerebral Hemorrhage Volume in Hypertensive Patients |
| title_full_unstemmed | Predictors of the Intracerebral Hemorrhage Volume in Hypertensive Patients |
| title_short | Predictors of the Intracerebral Hemorrhage Volume in Hypertensive Patients |
| title_sort | predictors of the intracerebral hemorrhage volume in hypertensive patients |
| topic | Brain hemorrhage Coagulation profile Hemorrhage volume Hypertension Intracerebral hemorrhage Warfarin |
| url | http://www.karger.com/Article/FullText/323270 |
| work_keys_str_mv | AT mohammadwasay predictorsoftheintracerebralhemorrhagevolumeinhypertensivepatients AT adnanyousuf predictorsoftheintracerebralhemorrhagevolumeinhypertensivepatients AT darshanlal predictorsoftheintracerebralhemorrhagevolumeinhypertensivepatients AT safiaawan predictorsoftheintracerebralhemorrhagevolumeinhypertensivepatients |