title: Determinants and Prognostic Significance of Hematoma Sedimentation Levels in Acute Intracerebral Hemorrhage.
abstract: BACKGROUND
  This study aimed at identifying the determinants and prognostic significance of a sedimentation level (fluid-blood level) in the hematoma among patients with acute intracerebral hemorrhage (ICH) who participated in the main Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2).
  
  
  METHODS
  Post-hoc analysis of the INTERACT2 dataset, a randomized controlled trial of patients with acute ICH with elevated systolic blood pressure (SBP), randomly assigned to intensive (target SBP <140 mm Hg) or guideline-based (<180 mm Hg) BP management. Patients with a sedimentation level at baseline assessment on CT, and modified Rankin Scale score at 90-day, were included in these analyses. Factors associated with a sedimentation level and its significance in relation to 90-day clinical outcomes were assessed in univariable and multivariable logistic regression models.
  
  
  RESULTS
  Of 2,065 participants, 19 (1%) had sedimentation level on baseline CT, which was independently associated with warfarin use (p = 0.006) and lobar ICH (p = 0.025). Sedimentation level was also associated with death or major disability at 90-day in both crude (84 vs. 53%; p = 0.014) and multivariable analyses adjusted for age, gender, Chinese region, warfarin use, baseline National Institutes of Health Stroke Scale score, onset to CT time, volume and location of ICH, intraventricular extension, and randomized intensive BP lowering (OR 3.94, 95% CI 1.01-15.37; p = 0.049).
  
  
  CONCLUSIONS
  The presence of hematoma sedimentation level on baseline CT is associated with warfarin use and lobar location of ICH, and predicts a worse outcome. Although uncommon, sedimentation level is an easily detectable prognostic factor in acute ICH.
authors.affiliation: The George Institute for Global Health, The University of Sydney and Royal Prince Alfred Hospital, Sydney, N.S.W., Australia.
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Sato
authors.forename: Candice
authors.initials: C
authors.lastname: Delcourt
authors.forename: Shihong
authors.initials: S
authors.lastname: Zhang
authors.forename: Hisatomi
authors.initials: H
authors.lastname: Arima
authors.forename: Emma
authors.initials: E
authors.lastname: Heeley
authors.forename: Danni
authors.initials: D
authors.lastname: Zheng
authors.forename: Rustam
authors.initials: R
authors.lastname: Al-Shahi Salman
authors.forename: Christian
authors.initials: C
authors.lastname: Stapf
authors.forename: Christophe
authors.initials: C
authors.lastname: Tzourio
authors.forename: Thompson
authors.initials: T
authors.lastname: Robinson
authors.forename: Richard I
authors.initials: RI
authors.lastname: Lindley
authors.forename: John
authors.initials: J
authors.lastname: Chalmers
authors.forename: Craig S
authors.initials: CS
authors.lastname: Anderson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002543:Cerebral Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D019468:Disease Management; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000628:therapy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014859:Warfarin / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D000959:Antihypertensive Agents; D014859:Warfarin