title: Higher mortality in patients with right hemispheric intracerebral haemorrhage: INTERACT1 and 2.
abstract: OBJECTIVE
  Controversy exists over the prognostic significance of the affected hemisphere in stroke. We aimed to determine the relationship between laterality of acute intracerebral haemorrhage (ICH) and poor clinical outcomes.
  
  
  METHODS
  A subsidiary analysis of the INTERACT Pilot and INTERACT2 studies--randomised controlled trials of patients with spontaneous acute ICH with elevated systolic blood pressure (BP), randomly assigned to intensive (target systolic BP <140 mm Hg) or guideline-based (<180 mm Hg) BP management. Outcomes were the combined and separate end points of death and major disability (modified Rankin scale (mRS) scores of 3-6, 6 and 3-5, respectively) at 90 days.
  
  
  RESULTS
  A total of 2708 patients had supratentorial/hemispheric ICH and information on mRS at 90 days. Patients with right hemispheric ICH (1327, 49%) had a higher risk of death at 90 days compared to those with left hemispheric ICH after adjustment for potential confounding variables (OR, 1.77 (95% CI 1.33 to 2.37)). There were no differences between patients with right and left hemispheric ICH regarding the combined end point of death or major disability or major disability in the multivariable-adjusted models (1.07 (0.89 to 1.29) and 0.85 (0.72 to 1.01), respectively).
  
  
  CONCLUSIONS
  Right hemispheric lesion was associated with increased risk of death in patients with acute ICH. The laterality of the ICH does not appear to affect the level of disability in survivors.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT00226096 and NCT00716079.
authors.affiliation: The George Institute for Global Health, the University of Sydney and Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
authors.forename: Shoichiro
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authors.lastname: Sato
authors.affiliation: The George Institute for Global Health, the University of Sydney and Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
authors.forename: Emma
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authors.lastname: Heeley
authors.affiliation: The George Institute for Global Health, the University of Sydney and Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
authors.forename: Hisatomi
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authors.affiliation: The George Institute for Global Health, the University of Sydney and Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
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authors.affiliation: The George Institute for Global Health, the University of Sydney and Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
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authors.affiliation: Lalitha Super Specialities Hospital, Guntur, Andhra Pradesh, India.
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authors.affiliation: Department of Neurology, The Fifth Affiliated Hospital, Sun Yat-Sen University, Guangdong, China.
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authors.affiliation: Department of Neurology, Chang Ning District Central Hospital, Shanghai, China.
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authors.affiliation: Department of Neurology, Shijiazhuang 260 Hospital, Hebei, China.
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authors.affiliation: Department of Neurology, University of Heidelberg UMM Mannheim, Mannheim, Germany.
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authors.affiliation: Department of Cardiovascular Sciences, and NIHR Biomedical Research Unit for Cardiovascular Diseases, University of Leicester, Leicester, UK.
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authors.affiliation: INSERM U897, University of Bordeaux, Bordeaux, France.
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authors.affiliation: The George Institute for Global Health, the University of Sydney and Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
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authors.affiliation: The George Institute for Global Health, the University of Sydney and Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
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authors.lastname: Chalmers
authors.affiliation: The George Institute for Global Health, the University of Sydney and Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
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authors.initials: QL
authors.lastname: Tao
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authors.lastname: Tai
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authors.initials: LJ
authors.lastname: Zhang
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authors.lastname: Xu
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authors.lastname: Cheng
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mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002423:Cause of Death; D002543:Cerebral Hemorrhage / Q000401:mortality* / Q000503:physiopathology; D004185:Disability Evaluation; D023381:Endpoint Determination; D005260:Female; D007839:Functional Laterality; D015600:Glasgow Coma Scale; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011379:Prognosis; D017741:Survivors; D016896:Treatment Outcome
keywords: CEREBROVASCULAR DISEASE