title: Subarachnoid extension of intracerebral hemorrhage and 90-day outcomes in INTERACT2.
abstract: OBJECTIVE
  The prognostic significance of subarachnoid extension of intracerebral hemorrhage was determined in the INTEnsive blood pressure Reduction in Acute Cerebral hemorrhage Trial (INTERACT2) study.
  
  
  METHODS
  INTERACT2 was an open randomized controlled trial of early intensive compared with guideline-recommended blood pressure lowering in patients with elevated systolic blood pressure within 6 hours of intracerebral hemorrhage. Independent predictors of death or major disability (scores 3-6 on the modified Rankin Scale) at 90 days were analyzed in logistic regression models.
  
  
  RESULTS
  Of 2582 participants, 192 (7%) had subarachnoid extension, which was associated with larger hematoma volumes (P<0.0001) and higher National Institute of Health Stroke Scale score (P<0.0001). Subarachnoid extension predicted death or major disability at 90 days (71% versus 53%; unadjusted odds ratio, 2.25; 95% confidence interval, 1.63-3.10; P<0.0001). The association remained significant after adjusting for age, region, lipid-lowering therapy, systolic blood pressure, glucose, location of hematoma, intraventricular extension, and randomized treatment (odds ratio, 2.17; 95% confidence interval, 1.50-3.14; P<0.0001), but not after further adjustment for baseline hematoma volume (P=0.62).
  
  
  CONCLUSIONS
  Subarachnoid extension of intracerebral hemorrhage is associated with poor prognosis, which is determined by a larger volume of the underlying intraparenchymal hematoma.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT00716079.
authors.affiliation: From the Department of Neurology (G.C.) and Department of Cardiology (P.Z.), Xuzhou Central Hospital, Jiangsu, China; The George Institute for Global Health, University of Sydney, Sydney, Australia (G.C., H.A., G.W., E.H., C.D., L.S., J.Y., X.W., Q.L., X.C., J.C., C.A.); Department of Neurology, Hebei Yutian Hospital, Tang Shan, China (G.W.); Department of Neurology, Mayo Clinic, Rochester, MN (A.A.R.); Department of Cardiovascular Sciences and NIHR Biomedical Research Unit for Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom (T.R.); Department of Neurology, Université Paris Diderot-Sorbonne Paris Cité, Paris, France (C.S.); Department of Neurology, Peking University First Hospital, Beijing, China (Y.H.); Department of Neurology, Shanghai 85th Hospital of PLA, Shanghai, China (L.S.); and Department of Neurology, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing, China (J.Y.).
authors.forename: Guofang
authors.initials: G
authors.lastname: Chen
authors.forename: Hisatomi
authors.initials: H
authors.lastname: Arima
authors.forename: Guojun
authors.initials: G
authors.lastname: Wu
authors.forename: Emma
authors.initials: E
authors.lastname: Heeley
authors.forename: Candice
authors.initials: C
authors.lastname: Delcourt
authors.forename: Peiying
authors.initials: P
authors.lastname: Zhang
authors.forename: Alejandro A
authors.initials: AA
authors.lastname: Rabinstein
authors.forename: Thompson
authors.initials: T
authors.lastname: Robinson
authors.forename: Christian
authors.initials: C
authors.lastname: Stapf
authors.forename: Yining
authors.initials: Y
authors.lastname: Huang
authors.forename: Lili
authors.initials: L
authors.lastname: Song
authors.forename: Jie
authors.initials: J
authors.lastname: Yang
authors.forename: Xia
authors.initials: X
authors.lastname: Wang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Chen
authors.forename: John
authors.initials: J
authors.lastname: Chalmers
authors.forename: Craig
authors.initials: C
authors.lastname: Anderson
mesh_terms: D000367:Age Factors; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D002543:Cerebral Hemorrhage / Q000401:mortality / Q000473:pathology*; D002552:Cerebral Ventricles / Q000473:pathology; D016001:Confidence Intervals; D004185:Disability Evaluation; D018450:Disease Progression; D017408:Guidelines as Topic; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D016015:Logistic Models; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D013345:Subarachnoid Hemorrhage / Q000401:mortality / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D000960:Hypolipidemic Agents
keywords: assessment, outcomes; cerebral hemorrhage; clinical trial