title: Hematoma growth and outcomes in intracerebral hemorrhage: the INTERACT1 study.
abstract: OBJECTIVE
  Uncertainty exists over the size of potential beneficial effects of medical treatments targeting hematoma growth in intracerebral hemorrhage (ICH). We report associations of hematoma growth parameters on clinical outcomes in the pilot phase, Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT1) (ClinicalTrials.gov NCT00226096).
  
  
  METHODS
  In randomized patients with both baseline and 24-hour brain CT (n = 335), associations between measures of absolute and relative hematoma growth and 90-day poor outcomes of death and dependency (modified Rankin Scale score 3-5) were assessed in logistic regression models, with data reported as odds ratios (OR) and 95% confidence intervals (CI).
  
  
  RESULTS
  A total of 10.7 mL (1 SD) increase in hematoma volume over 24 hours was strongly associated with poor outcome (adjusted OR 1.72, 95% CI 1.19-2.49; p = 0.004). An association was also evident for relative growth (adjusted OR 1.67, 95% 1.22-2.27; p = 0.001 for 1 SD increase). The analyses were adjusted for age, sex, achieved systolic blood pressure, elevated NIH Stroke Scale score (≥ 14), hematoma location, baseline hematoma volume, intraventricular extension, antithrombotic therapy, baseline glucose, time from ICH to baseline CT scan, and time from baseline to repeat CT scan. A 1 mL increase in hematoma growth was associated with a 5% (95% CI 2%-9%) higher risk of death or dependency.
  
  
  CONCLUSIONS
  Medical treatments, such as rapid intensive blood pressure lowering, could achieve ∼2-4 mL absolute attenuation of hematoma growth. There is hope that this could translate into modest but still clinically worthwhile (∼10%-20% better chance) outcome from ICH.
authors: The George Institute for Global Health, Royal Prince Alfred Hospital, University of Sydney, Australia.
authors: Candice
authors: C
authors: Delcourt
authors: Yining
authors: Y
authors: Huang
authors: Hisatomi
authors: H
authors: Arima
authors: John
authors: J
authors: Chalmers
authors: Stephen M
authors: SM
authors: Davis
authors: Emma L
authors: EL
authors: Heeley
authors: Jiguang
authors: J
authors: Wang
authors: Mark W
authors: MW
authors: Parsons
authors: Guorong
authors: G
authors: Liu
authors: Craig S
authors: CS
authors: Anderson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002543:Cerebral Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging*; D018450:Disease Progression; D005260:Female; D006406:Hematoma / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011859:Radiography; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents