title: Current management of intracerebral haemorrhage in China: a national, multi-centre, hospital register study.
abstract: BACKGROUND
  We aimed to examine current practice of the management and secondary prevention of intracerebral haemorrhage (ICH) in China where the disease is more common than in Western populations.
  
  
  METHODS
  Data on baseline characteristics, management in-hospital and post-stroke, and outcome of ICH patients are from the ChinaQUEST (QUality Evaluation of Stroke Care and Treatment) study, a multi-centre, prospective, 62 hospital registry in China during 2006-07.
  
  
  RESULTS
  Nearly all ICH patients (n = 1572) received an intravenous haemodiluting agent such as mannitol (96%) or a neuroprotectant (72%), and there was high use of intravenous traditional Chinese medicine (TCM) (42%). Neurosurgery was undertaken in 137 (9%) patients; being overweight, having a low Glasgow Coma Scale (GCS) score on admission, and Total Anterior Circulation Syndrome (TACS) clinical pattern on admission, were the only baseline factors associated with this intervention in multivariate analyses. Neurosurgery was associated with nearly three times higher risk of death/disability at 3 months post-stroke (odd ratio [OR] 2.60, p < 0.001). Continuation of antihypertensives in-hospital and at 3 and 12 months post-stroke was reported in 732/935 (78%), 775/935 (83%), and 752/935 (80%) living patients with hypertension, respectively.
  
  
  CONCLUSIONS
  The management of ICH in China is characterised by high rates of use of intravenous haemodiluting agents, neuroprotectants, and TCM, and of antihypertensives for secondary prevention. The controversial efficacy of these therapies, coupled with the current lack of treatments of proven benefit, is a call for action for more outcomes based research in ICH.
authors.affiliation: The George Institute for Global Health, Royal Prince Alfred Hospital and University of Sydney, Sydney, Australia. jwei@georgeinstitute.org.au
authors.forename: Jade W
authors.initials: JW
authors.lastname: Wei
authors.forename: Yining
authors.initials: Y
authors.lastname: Huang
authors.forename: Ji-Guang
authors.initials: JG
authors.lastname: Wang
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
authors.forename: Lawrence K S
authors.initials: LK
authors.lastname: Wong
authors.forename: Qifang
authors.initials: Q
authors.lastname: Huang
authors.forename: Li'e
authors.initials: L
authors.lastname: Wu
authors.forename: Emma L
authors.initials: EL
authors.lastname: Heeley
authors.forename: Hisatomi
authors.initials: H
authors.lastname: Arima
authors.forename: Craig S
authors.initials: CS
authors.lastname: Anderson
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D002543:Cerebral Hemorrhage / Q000188:drug therapy* / Q000601:surgery*; D002681:China; D005260:Female; D006438:Hemodilution / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control*; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008353:Mannitol; D008516:Medicine, Chinese Traditional / Q000706:statistics & numerical data; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000627:therapeutic use; D019635:Neurosurgical Procedures / Q000706:statistics & numerical data; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods
chemical_list: D000959:Antihypertensive Agents; D018696:Neuroprotective Agents; D008353:Mannitol