Details

Autor(en) / Beteiligte

• Hostettler, Isabel C
• Schwarz, Ghil
• Ambler, Gareth
• Wilson, Duncan
• Banerjee, Gargi
• Seiffge, David J
• Shakeshaft, Clare
• Lunawat, Surabhika
• Cohen, Hannah
• Yousry, Tarek A
• Al-Shahi Salman, Rustam
• Lip, Gregory Y H
• Brown, Martin M
• Muir, Keith W
• Houlden, Henry
• Jäger, Hans Rolf
• Werring, David J

Titel

Cerebral Small Vessel Disease and Functional Outcome Prediction After Intracerebral Hemorrhage

Ist Teil von

• Neurology, 2021-04, Vol.96 (15), p.e1954

Ort / Verlag

United States

Erscheinungsjahr

2021

Quelle

MEDLINE

Beschreibungen/Notizen

• To determine whether CT-based cerebral small vessel disease (SVD) biomarkers are associated with 6-month functional outcome after intracerebral hemorrhage (ICH) and whether these biomarkers improve the performance of the preexisting ICH prediction score. We included 864 patients with acute ICH from a multicenter, hospital-based prospective cohort study. We evaluated CT-based SVD biomarkers (white matter hypodensities [WMH], lacunes, brain atrophy, and a composite SVD burden score) and their associations with poor 6-month functional outcome (modified Rankin Scale score >2). The area under the receiver operating characteristic curve (AUROC) and Hosmer-Lemeshow test were used to assess discrimination and calibration of the ICH score with and without SVD biomarkers. In multivariable models (adjusted for ICH score components), WMH presence (odds ratio [OR] 1.52, 95% confidence interval [CI] 1.12-2.06), cortical atrophy presence (OR 1.80, 95% CI 1.19-2.73), deep atrophy presence (OR 1.66, 95% CI 1.17-2.34), and severe atrophy (either deep or cortical) (OR 1.94, 95% CI 1.36-2.74) were independently associated with poor functional outcome. For the revised ICH score, the AUROC was 0.71 (95% CI 0.68-0.74). Adding SVD markers did not significantly improve ICH score discrimination; for the best model (adding severe atrophy), the AUROC was 0.73 (95% CI 0.69-0.76). These results were confirmed when lobar and nonlobar ICH were considered separately. The ICH score has acceptable discrimination for predicting 6-month functional outcome after ICH. CT biomarkers of SVD are associated with functional outcome, but adding them does not significantly improve ICH score discrimination. ClinicalTrials.gov Identifier: NCT02513316.