Clinical features associated with early hospital arrival after acute intracerebral hemorrhage: Challenges for new trials

Clinical features associated with early hospital arrival after acute intracerebral hemorrhage: Challenges for new trials

Author Valiente, Raul Alberto Google Scholar
Miranda-Alves, Maramelia Araujo de Autor UNIFESP Google Scholar
Silva, Gisele Sampaio Autor UNIFESP Google Scholar
Gomes, Daniela Laranja Google Scholar
Brucki, Sonia Maria Dozzi Google Scholar
Guimaraes Rocha, Maria Sheila Google Scholar
Massaro, Ayrton Roberto Google Scholar
Institution Hosp Santa Marcelina
Universidade Federal de São Paulo (UNIFESP)
Ctr Diagnost Fleury
Abstract Background: Early hospital admission followed by correct diagnosis with minimum delay is a prerequisite for successful new interventions in acute intracerebral hemorrhage (ICH). the aim of this study was to evaluate clinical features associated with early hospital arrival in ICH patients and their influence on the outcome. Methods: Data from all patients arriving within 24 h of the ICH onset were prospectively collected at 2 stroke centers in São Paulo, Brazil. the cutoff of 3 h was chosen to select 2 groups: 0-3 h (early) and > 3-24 h (late). Results: We identified 91 ICH patients (mean age 57.9 years, 62% men, 63% white) admitted within the first 24 h of symptom onset between March 2004 and April 2005. Systolic blood pressure, mean arterial pressure and pulse pressure were significantly higher in patients arriving within 3 h. Patients that arrived early also had a higher NIHSS score (p = 0.003), a lower Glasgow Coma Score (p = 0.001) and presence of intraventricular hemorrhage (p = 0.02). Lower ICH scores were more frequent in those that arrived late. Fourteen patients showed hematoma enlargement and the majority of them (n = 13) were admitted within the first 3 h from symptom onset (p = 0.01). Patients who arrived within the 3-hour window had a higher 30-day mortality (p = 0.0008) and a worse Rankin score after 6 months (p = 0.001). Conclusions: Treatment decisions in acute ICH may need to establish new combined approaches to maximize the number of eligible patients for early therapy considering the interactions between independent outcome predictors presented at early onset. Copyright (C) 2008 S. Karger AG, Basel.
Keywords hematoma enlargement
intracerebral hemorrhage
Language English
Date 2008-01-01
Published in Cerebrovascular Diseases. Basel: Karger, v. 26, n. 4, p. 404-408, 2008.
ISSN 1015-9770 (Sherpa/Romeo, impact factor)
Publisher Karger
Extent 404-408
Origin http://dx.doi.org/10.1159/000151681
Access rights Closed access
Type Article
Web of Science ID WOS:000259725600010
URI http://repositorio.unifesp.br/handle/11600/30358

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