Time to Anticoagulation Reversal and Outcomes After Intracerebral Hemorrhage

JAMA Neurology, Journal Year: 2024, Volume and Issue: 81(4), P. 363 - 363

Published: Feb. 9, 2024

Intracerebral hemorrhage (ICH) is the deadliest stroke subtype, and mortality rates are especially high in anticoagulation-associated ICH. Recently, specific anticoagulation reversal strategies have been developed, but it not clear whether there a time-dependent treatment effect for door-to-treatment (DTT) times clinical practice.

Language: Английский

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Triglyceride glucose index is a significant predictor of severe disturbance of consciousness and all-cause mortality in critical cerebrovascular disease patients

Cardiovascular Diabetology, Journal Year: 2023, Volume and Issue: 22(1)

Published: June 29, 2023

Abstract Objective The association of the triglyceride-glucose (TyG) index with severe consciousness disturbance and in-hospital mortality in patients cerebrovascular disease intensive care unit (ICU) is unclear. This study aimed to investigate TyG index’s predictive ability on severity impaired ICU. Method Patients diagnosed non-traumatic cerebral hemorrhage infarction were extracted from MIMIC-IV database analyzed as two cohorts. between patients’ impairment was using logistic regression models. Using restricted cubic spline curves, we potential nonlinear relationships indices outcome indicators. receiver operating characteristic (ROC) curves utilized evaluate for Result study’s last cohorts comprised 537 traumatic 872 infarction. a significant predictor disease, determined by regression. risk increased roughly linearly increasing index. Conclusion found be death ICU, it provides some value disturbances patients.

Language: Английский

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Acute Spontaneous Lobar Cerebral Hemorrhages Present a Different Clinical Profile and a More Severe Early Prognosis than Deep Subcortical Intracerebral Hemorrhages—A Hospital-Based Stroke Registry Study

Biomedicines, Journal Year: 2023, Volume and Issue: 11(1), P. 223 - 223

Published: Jan. 16, 2023

Acute spontaneous intracerebral hemorrhage (ICH) is the most severe stroke subtype, with a high risk of death, dependence, and dementia. Knowledge about clinical profile early outcomes ICH patients lobar versus deep subcortical brain topography remains limited. In this study, we investigated effects on demographics, cerebrovascular factors, characteristics, in sample 298 consecutive acute (165 133 hemorrhagic stroke) available single-center-based registry over 24 years. The multiple logistic regression analysis shows that variables independently associated were seizures (OR 6.81, CI 95% 1.27−5.15), chronic liver disease 4.55, 1.03−20.15), hemianopia 2.55, 1.26−5.15), headaches 1.90, IC 1.06−3.41), alcohol abuse (>80 gr/day) 0−10, 0.02−0,53), hypertension 0,41, 0.23−0−70), sensory deficit 0.43, 0.25−0.75), limb weakness (OR: 0.47, 0.24−0.93). in-hospital mortality was 26.7% for 16.5% ICH. study confirmed spectrum, prognosis, depend site bleeding, more prognosis hemorrhage.

Language: Английский

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Association of follow-up neutrophil-to-lymphocyte ratio and systemic inflammation response index with stroke-associated pneumonia and functional outcomes in cerebral hemorrhage patients: a case-controlled study

International Journal of Surgery, Journal Year: 2024, Volume and Issue: unknown

Published: March 18, 2024

Background: Neutrophil-to-lymphocyte ratio (NLR) and systemic inflammation response index (SIRI) at admission are independent diagnostic biomarkers in stroke-associated pneumonia (SAP). Our study aimed to investigate the association between NLR, SIRI, specifically follow-up NLR SAP, as well their relationship with functional outcomes. Materials Methods: We retrospectively included 451 consecutive ICH patients from May 2017 2019. conducted univariate multivariable analyses identify factors independently associated SAP poor Results: Compared 127 (28.16%) diagnosed those without had both lower baseline SIRI values ( P <0.001). After adjustments, we found that (OR, 1.039 [95% CI, 1.003-1.077]; =0.036) 1.054 1.011-1.098]; =0.012) were SAP. The was also a higher mRS 1.124 1.025-1.233]; =0.013) ADL-MBI score 1.167 1.057-1.289]; =0.002) discharge. Multivariable analysis indicated advanced age nasogastric tube feeding <0.05). constructed dynamic nomogram risk. Further subgroup revealed 1.062 1.007-1.120]; =0.026) is group, while 1.080 1.024-1.139]; =0.005) occurrence of non-nasogastric patients. Conclusions: elevated occurrence, increasing Inflammatory markers different stages may offer individualized guidance for receiving various treatments.

Language: Английский

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Development and validation of a machine learning-based predictive model for assessing the 90-day prognostic outcome of patients with spontaneous intracerebral hemorrhage

Journal of Translational Medicine, Journal Year: 2024, Volume and Issue: 22(1)

Published: March 4, 2024

Abstract Background Spontaneous intracerebral hemorrhage (sICH) is associated with significant mortality and morbidity. Predicting the prognosis of patients sICH remains an important issue, which significantly affects treatment decisions. Utilizing readily available clinical parameters to anticipate unfavorable holds notable significance. This study employs five machine learning algorithms establish a practical platform for prediction short-term prognostic outcomes in individuals afflicted sICH. Methods Within framework this retrospective analysis, model underwent training utilizing data gleaned from 413 cases center, subsequent validation employing external center. Comprehensive information, laboratory analysis results, imaging features pertaining were harnessed as learning. We developed validated efficacy using all selected models: Support Vector Machine (SVM), Logistic Regression (LR), Random Forest (RF), XGboost LightGBM, respectively. The process Recursive Feature Elimination (RFE) was executed optimal feature screening. An internal five-fold cross-validation employed pinpoint most suitable hyperparameters model, while implemented discern demonstrating superior average performance. Finally, best performance our final it validation. Evaluation model’s comprehensively conducted through utilization ROC curve, accuracy, other relevant indicators. SHAP diagram utilized elucidate variable importance within culminating amalgamation above metrics succinct platform. Results A total collected 180 poor prognosis. 74 26 set, test set AUC values SVM, LR, RF, XGBoost, LightGBM models recorded 0.87, 0.896, 0.916, 0.885, 0.912, RF (average AUC: 0.906 ± 0.029, P < 0.01). still maintains good 0.817 (95% CI 0.705–0.928). Pertaining attributes patients, NIHSS score reigned supreme, succeeded by AST, Age, white blood cell, hematoma volume, among others. In culmination, guided weight model's curve insights, score, volume integrated forge tailored patients. Conclusion constructed based on results incorporating clinically accessible predictors reliable predictive Meanwhile, also more stable, can be used accurate

Language: Английский

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Predictors of early neurological deterioration in patients with intracerebral hemorrhage: a systematic review and meta-analysis

Journal of Neurology, Journal Year: 2024, Volume and Issue: 271(6), P. 2980 - 2991

Published: March 20, 2024

Language: Английский

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Minimally invasive surgeries for spontaneous hypertensive intracerebral hemorrhage (MISICH): a multicenter randomized controlled trial

BMC Medicine, Journal Year: 2024, Volume and Issue: 22(1)

Published: June 13, 2024

Abstract Background Intracerebral hemorrhage (ICH) is a common stroke type with high morbidity and mortality. There are mainly three surgical methods for treating ICH. Unfortunately, thus far, no specific method has been proven to be the most effective. We carried out this study investigate whether minimally invasive surgeries endoscopic surgery or stereotactic aspiration (frameless navigated aspiration) will improve functional outcomes in patients supratentorial ICH compared small-bone flap craniotomy. Methods In parallel-group multicenter randomized controlled trial conducted at 16 centers, hypertensive were receive surgery, aspiration, craniotomy 1:1:1 ratio from July 2016 June 2022. The follow-up duration was 6 months. Patients evacuation, primary outcome favorable outcome, defined as proportion of who achieved modified Rankin scale (mRS) score 0–2 6-month follow-up. Results A total 733 randomly allocated groups: 243 endoscopy group, 247 group. Finally, 721 (239 246 236 group) received treatment included intention-to-treat analysis. Primary efficacy analysis revealed that 73 219 (33.3%) 72 220 (32.7%) 47 212 (22.2%) group ( P = .017). got similar results subgroup deep hemorrhages, while lobar hemorrhages prognostic among groups. Old age, hematoma location, large volume, low preoperative GCS score, craniotomy, intracranial infection associated greater odds unfavorable outcomes. mean hospitalization expenses ¥92,420 ¥77,351 ¥100,947 .000). Conclusions Compared small bone improved long-term ICH, especially hemorrhages. Trial Registration ClinicalTrials.gov Identifier: NCT02811614.

Language: Английский

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Uncertainty-aware deep-learning model for prediction of supratentorial hematoma expansion from admission non-contrast head computed tomography scan

npj Digital Medicine, Journal Year: 2024, Volume and Issue: 7(1)

Published: Feb. 6, 2024

Hematoma expansion (HE) is a modifiable risk factor and potential treatment target in patients with intracerebral hemorrhage (ICH). We aimed to train validate deep-learning models for high-confidence prediction of supratentorial ICH expansion, based on admission non-contrast head Computed Tomography (CT). Applying Monte Carlo dropout entropy model predictions, we estimated the uncertainty identified at high HE confidence. Using receiver operating characteristics area under curve (AUC), compared performance multivariable visual markers determined by expert reviewers. randomly split multicentric dataset (4-to-1) into training/cross-validation (n = 634) versus test 159) cohorts. trained tested separate ≥6 mL ≥3 expansion. The achieved an AUC 0.81

Language: Английский

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Clot removAl with or without decompRessive craniectomy under ICP monitoring for supratentorial IntraCerebral Hemorrhage (CARICH): a randomized controlled trial

International Journal of Surgery, Journal Year: 2024, Volume and Issue: unknown

Published: April 19, 2024

Decompressive craniectomy (DC), a surgery to remove part of the skull and open dura mater, maybe an effective treatment for controlling intracranial hypertension. It remains great interest elucidate whether DC is beneficial intracerebral hemorrhage (ICH) patients who warrant clot removal (CR) prevent

Language: Английский

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Autonomic dysfunction and treatment strategies in intracerebral hemorrhage

CNS Neuroscience & Therapeutics, Journal Year: 2024, Volume and Issue: 30(2)

Published: Feb. 1, 2024

Autonomic dysfunction with central autonomic network (CAN) damage occurs frequently after intracerebral hemorrhage (ICH) and contributes to a series of adverse outcomes. This review aims provide insight convenience for future clinical practice research on in ICH patients.

Language: Английский

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