Multivariate analysis of risk factors of hematoma expansion in spontaneous intracerebral hemorrhage

被引:49
作者
Lim, Jae Kwan [1 ]
Hwang, Hyung Sik [1 ]
Cho, Byung Moon [1 ]
Lee, Ho Kook [1 ]
Ahn, Sung Ki [1 ]
Oh, Sae Moon [1 ]
Choi, Sun Kil [1 ]
机构
[1] Hallym Univ, Coll Med, Dept Neurosurg, Seoul 150030, South Korea
来源
SURGICAL NEUROLOGY | 2008年 / 69卷 / 01期
关键词
hematoma expansion; spontaneous intracerebral hemorrhage; diastolic blood pressure;
D O I
10.1016/j.surneu.2007.07.025
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Back ground: We focused on the cause of hematoma expansion after admission because the volume of hematoma after S-ICH plays a crucial role in the cause of mortality and morbidity. Methods: In a retrospective review, 51 patients with hematoma expansion of S-ICH were identified among 880 cases of S-ICH treated between 2001 and May 2006. We divided cases into 2 groups according to the time of hematoma expansion. An enlargement of hematoma within 2 weeks after hospitalization was categorized as the acute stage group and after 2 weeks was categorized as the chronic stage group. Spontaneous intracerebral hemorrhage without hematoma expansion group (100 cases) had been consecutively selected as a control group. We analyzed the risk factors of hematoma expansion in patients with S-ICH especially in the acute stage group. Results: Fifty-one of 880 patients had the enlargement of hematoma (5.8%). Forty-three (84%) of 51 cases were acutely developed and 8 cases (16%) were developed chronically. On univariate analysis there were significant differences in BP within the initial 48 hours (P < .0001), GOS (P < .0001), and previously taking anticoagulant agents (P = .0053). Especially the difference in SBP and DBP within 48 hours between groups was 19 (11%) and 13 mm Hg (14%), respectively. The DBP within the initial 24 hours had a meaningful odds ratio (1.06) on logistic regression analysis. Conclusion: A reduction of BP by 15% (SBP <= 140 nun Hg, DBP <= 80 mm Hg) is necessary at acute stage in S-ICH. (C) 2008 Elsevier Inc. All rights reserved.
引用
收藏
页码:40 / 45
页数:6
相关论文
共 38 条
  • [31] Qureshi Adnan I, 2005, J Intensive Care Med, V20, P34, DOI 10.1177/0885066604271619
  • [32] Metalloproteinase inhibition blocks edema in intracerebral hemorrhage in the rat
    Rosenberg, GA
    Navratil, M
    [J]. NEUROLOGY, 1997, 48 (04) : 921 - 926
  • [33] Sandercock P, 1997, LANCET, V349, P1569
  • [34] Treatment and prevention of primary intracerebral hemorrhage
    Towfighi, A
    Greenberg, SM
    Rosand, J
    [J]. SEMINARS IN NEUROLOGY, 2005, 25 (04) : 445 - 452
  • [35] Blood pressure course in acute ischaemic stroke in relation to stroke subtype
    Vemmos, KN
    Tsivgoulis, G
    Spengos, K
    Synetos, A
    Manios, E
    Vassilopoulou, S
    Zis, V
    Zakopoulos, N
    [J]. BLOOD PRESSURE MONITORING, 2004, 9 (03) : 107 - 114
  • [36] Factors influencing acute blood pressure values in stroke subtypes
    Vemmos, KN
    Spengos, K
    Tsivgoulis, G
    Zakopoulos, N
    Manios, E
    Kotsis, V
    Daffertshofer, M
    Vassilopoulos, D
    [J]. JOURNAL OF HUMAN HYPERTENSION, 2004, 18 (04) : 253 - 259
  • [37] Role of blood clot formation on early edema development after experimental intracerebral hemorrhage
    Xi, GH
    Wagner, KR
    Keep, RF
    Hua, Y
    de Courten-Myers, GM
    Broderick, JP
    Brott, TG
    Hoff, JT
    [J]. STROKE, 1998, 29 (12) : 2580 - 2585
  • [38] HYPERTENSION IN ACUTE ISCHEMIC STROKES - NOT TO TREAT
    YATSU, FM
    ZIVIN, J
    [J]. ARCHIVES OF NEUROLOGY, 1985, 42 (10) : 999 - 1000