Impact of Low Ambient Temperature on the Occurrence of Spontaneous Intracerebral Hemorrhage-Analysis of Population-Based Stroke Registry in Toyama, Japan

Background Atrial fibrillation (AF) represents a major indication for oral anticoagulants (OAC) that contribute to spontaneous intracerebral hemorrhage (ICH). This study evaluated AF prevalence among patients with ICH, temporal trends, and early functional outcomes and death of patients. Methods and Results Patients with first‐ever ICH were prospectively recorded in the population‐based stroke registry of Dijon, France, (2006–2017). Association between AF and early outcome of patients with ICH (ordinal modified Rankin Scale score and death at discharge) were analyzed using ordinal and logistic regressions. Among 444 patients with ICH, 97 (21.9%) had AF, including 65 (14.6%) with previously known AF treated with OAC, and 13 (2.9%) with newly diagnosed AF. AF prevalence rose from 17.2% (2006–2011) to 25.8% (2012–2017) ( P ‐trend=0.05). An increase in the proportion of AF treated with OAC (11.3% to 17.5%, P ‐trend=0.09) and newly diagnosed AF (1.5% to 4.2%, P ‐trend=0.11) was observed. In multivariable analyses, after adjustment for premorbid OAC, AF was not significantly associated with ordinal modified Rankin Scale score (odds ratio [OR], 1.29; 95% CI, 0.69–2.42) or death (OR, 0.89; 95% CI, 0.40–1.96) in patients with ICH. Nevertheless, adjusted premorbid OAC use remained highly associated with a higher probability of death (OR, 2.53; 95% CI, 1.11–5.78). Conclusions AF prevalence and use of OAC among patients with ICH increased over time. Premorbid use of OAC was associated with poor outcome after ICH, thus suggesting a need to better identify ICH risk before initiating or pursuing OAC therapy in patients with AF, and to develop acute treatment and secondary prevention strategies after ICH in patients with AF.

Download Full-text

Abstract P256: Association Between Antidepressants Use and Intracerebral Hemorrhage: Florida Stroke Registry

Stroke ◽

10.1161/str.52.suppl_1.p256 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Mithilesh Siddu ◽

Antonio Bustillo ◽

Carolina M Gutierrez ◽

Kefeng Wang ◽

Hannah Gardener ◽

...

Keyword(s):

Intracerebral Hemorrhage ◽

Oral Anticoagulants ◽

Large Population ◽

Multivariable Analysis ◽

Population Based ◽

Prior History ◽

Stroke Registry ◽

The Us ◽

History Of ◽

Antidepressant Use

Introduction: SSRIs, the most commonly prescribed antidepressants (AD) in the US, are linked to an increased intracerebral hemorrhage (ICH) risk possibly related to impaired platelet function. In the Florida Stroke Registry (FSR), we studied the proportion of cases presenting with ICH amongst AD users and the rate of SSRI prescription amongst stroke patients discharged on AD. Methods: From Jan 2010 to Dec 2019 we included 127,915 cases from FSR in whom information on AD use was available. Multivariable logistic regression was used to evaluate ICH proportions amongst AD and non-AD users and rates of prescribed SSRIs at discharge. Results: The rate of ICH amongst prior AD users (n=17,009, median age 74, IQR=19) and non-AD users (n=110,906, median age 72, IQR=21) were 11% and 14% respectively. Prior AD users were more likely to be female (17% vs. 10% male), non-Hispanic White (16% vs. 8% non-Hispanic Black vs. 12% Florida Hispanic vs. 6% Puerto Rican Hispanic), have hypertension (HTN) (14.% vs. 10%), diabetes mellitus (DM) (16% vs.12%), use oral anticoagulants (OAC) (17 % vs. 13%), antiplatelets (AP; 17% vs. 11%), and statins (17% vs. 10%) prior to hospital presentation. In multivariable analysis adjusting for age, race, prior history of HTN, DM, prior OAC, AP and statin use, AD users just as likely to present with spontaneous ICH as compared to non-AD users (OR=0.92, 95% CI 0.85, 1.01). A total of 3.4% of all ICH patients and 9% of those in whom AD information was available were discharged home on an AD (74 % SSRI, 24% other AD). Conclusion: In this large population-based study, we did not find an association between prior AD use and an increased rate of ICH. Importantly AD (mostly SSRIs) are commonly prescribed to patients with ICH in routine clinical practice. The association between types, duration, and safety of antidepressant use in ICH patients deserves further studies.

Download Full-text

FP26-TU-06 The association between ambient temperature and spontaneous intracerebral hemorrhage in Southern Taiwan: a case series of 350 patients

Journal of the Neurological Sciences ◽

10.1016/s0022-510x(09)70407-1 ◽

2009 ◽

Vol 285 ◽

pp. S99

Author(s):

C.W. Fang ◽

P.S. Sung ◽

C.S. Yang ◽

L.C. Hung ◽

Y.J. Wu ◽

...

Keyword(s):

Intracerebral Hemorrhage ◽

Ambient Temperature ◽

Case Series ◽

Spontaneous Intracerebral Hemorrhage ◽

Southern Taiwan

Download Full-text

Low cholesterol level associated with severity and outcome of spontaneous intracerebral hemorrhage: Results from Taiwan Stroke Registry

PLoS ONE ◽

10.1371/journal.pone.0171379 ◽

2017 ◽

Vol 12 (4) ◽

pp. e0171379 ◽

Cited By ~ 9

Author(s):

Yu-Wei Chen ◽

Chen-Hua Li ◽

Chih-Dong Yang ◽

Chung-Hsiang Liu ◽

Chih-Hung Chen ◽

...

Keyword(s):

Intracerebral Hemorrhage ◽

Cholesterol Level ◽

Spontaneous Intracerebral Hemorrhage ◽

Stroke Registry ◽

Low Cholesterol

Download Full-text

In-Hospital Mortality and Complication Rates in Surgically and Conservatively Treated Patients with Spontaneous Intracerebral Hemorrhage in Central Europe: A Population-Based Study

World Neurosurgery ◽

10.1016/j.wneu.2015.11.075 ◽

2016 ◽

Vol 88 ◽

pp. 306-310 ◽

Cited By ~ 4

Author(s):

Marco Stein ◽

Gerhard F. Hamann ◽

Björn Misselwitz ◽

Eberhard Uhl ◽

Malgorzata Kolodziej ◽

...

Keyword(s):

Intracerebral Hemorrhage ◽

Hospital Mortality ◽

Central Europe ◽

Population Based ◽

Complication Rates ◽

Spontaneous Intracerebral Hemorrhage ◽

Population Based Study

Download Full-text

Increasing early ambulation disability in spontaneous intracerebral hemorrhage survivors

Neurology ◽

10.1212/wnl.0000000000005633 ◽

2018 ◽

Vol 90 (23) ◽

pp. e2017-e2024 ◽

Cited By ~ 3

Author(s):

Yannick Béjot ◽

Christelle Blanc ◽

Benoit Delpont ◽

Pierre Thouant ◽

Cécile Chazalon ◽

...

Keyword(s):

Logistic Regression ◽

Intracerebral Hemorrhage ◽

Acute Care ◽

Temporal Trends ◽

Population Based ◽

Spontaneous Intracerebral Hemorrhage ◽

Early Ambulation ◽

Logistic Regression Models ◽

Population Based Registry ◽

Care Ward

ObjectiveTo evaluate temporal trends in early ambulatory status in patients with spontaneous intracerebral hemorrhage (ICH).MethodsAll patients with ICH between 1985 and 2011 were prospectively registered in a population-based registry in Dijon, France, and included in the study. Outcomes of ICH survivors were assessed at discharge from their stay in an acute care ward with the use of a 4-grade ambulation scale. Time trends in ambulation disability and place of discharge were analyzed in 3 periods (1985–1993, 1994–2002, and 2003–2011). Multivariable ordinal and logistic regression models were applied.ResultsFive hundred thirty-one patients with ICH were registered, of whom 200 (37.7%) died in the acute care ward. While the proportion of deaths decreased over time, that of patients with ambulation disability increased (odds ratio [OR] 1.67, 95% confidence interval [CI] 0.87–3.23, p = 0.124 for 1994–2002; and OR 1.97, 95% CI, 1.08–3.60, p = 0.027 for 2003–2011 vs 1985–1993 in ordinal logistic regression). The proportion of patients dependent in walking rose (OR 2.11, 95% CI 1.16–3.82, p = 0.014 for 1994–2002; and OR 2.73; 95% CI 1.54–4.84, p = 0.001 for 2003–2011), and the proportion of patients discharged to home decreased (OR 0.49, 95% CI 0.24–0.99, p = 0.048 for 1994–2002; and OR 0.32, 95% CI 0.16–0.64, p = 0.001 for 2003–2011).ConclusionThe decrease in in-hospital mortality of patients with ICH translated into a rising proportion of patients with ambulation disability at discharge. A lower proportion of patients returned home. These results have major implications for the organization of postacute ICH care.

Download Full-text

Seasonal Variation in Incidence of Stroke in a General Population of 1.4 Million Japanese: The Shiga Stroke Registry

Cerebrovascular Diseases ◽

10.1159/000518370 ◽

2021 ◽

pp. 1-7

Author(s):

Takako Fujii ◽

Hisatomi Arima ◽

Naoyuki Takashima ◽

Yoshikuni Kita ◽

Naomi Miyamatsu ◽

...

Keyword(s):

Ischemic Stroke ◽

Seasonal Variation ◽

General Population ◽

Intracerebral Hemorrhage ◽

Large Scale ◽

Population Based ◽

Incidence Rates ◽

Stroke Incidence ◽

Stroke Registry ◽

Age And Sex

Introduction: The purpose of this study was to investigate seasonal variation in stroke incidence using data from a large-scale stroke registry of general population in current Japan. Methods: Shiga Stroke Registry (SSR) is an ongoing population-based registry of stroke that occurred in the Shiga Prefecture in central Honshu, Japan. A total 6,688 cases of first-ever stroke, with onset dates ranging from 1 January 2011 to 31 December in 2013 were included in this study. Incidence rates of first-ever stroke in each season were estimated using the person-year approach and adjusted for age and sex using the Poisson regression models. Results: From 2011 to 2013, we identified a total of 6,688 stroke cases (3,570 men, 3,118 women), of which 4,480 cases had ischemic stroke (2,518 men, 1,962 women), 1,588 had intracerebral hemorrhage (857 men, 731 women) and 563 had subarachnoid hemorrhage (166 men, 397 women). Age- and sex-adjusted incidence rates of total stroke were 151 (95% confidence interval [CI] 144–160, p = <0.001 vs. summer) in spring, 130 (95% CI 122–137) in summer, 141 (95% CI 133–149, p = 0.020 vs. summer) in autumn and 170 (95% CI 161–179, p = <0.001 vs. summer) in winter. Seasonal variation was more pronounced in intracerebral hemorrhage than in ischemic stroke. Conclusion: In the present large-scale stroke registry of general population, incidence rates of stroke were highest in winter and lowest in summer in current Japan.

Download Full-text

Defining Prolonged Length of Acute Care Stay for Surgically and Conservatively Treated Patients with Spontaneous Intracerebral Hemorrhage: A Population-Based Analysis

BioMed Research International ◽

10.1155/2016/9095263 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 7

Author(s):

Marco Stein ◽

Björn Misselwitz ◽

Gerhard F. Hamann ◽

Malgorzata A. Kolodziej ◽

Marcus H. T. Reinges ◽

...

Keyword(s):

Intracerebral Hemorrhage ◽

Acute Care ◽

Population Based ◽

Surgical Patients ◽

Change Points ◽

Spontaneous Intracerebral Hemorrhage ◽

Prolonged Length ◽

Number Of Patients ◽

Baseline Characteristics ◽

Definition Of

Background. The definition of prolonged length of stay (LOS) during acute care remains unclear among surgically and conservatively treated patients with intracerebral hemorrhage (ICH).Methods. Using a population-based quality assessment registry, we calculated change points in LOS for surgically and conservatively treated patients with ICH. The influence of comorbidities, baseline characteristics at admission, and in-hospital complications on prolonged LOS was evaluated in a multivariate model.Results. Overall, 13272 patients with ICH were included in the analysis. Surgical therapy of the hematoma was documented in 1405 (10.6%) patients. Change points for LOS were 22 days (CI: 8, 22; CL 98%) for surgically treated patients and 16 days (CI: 16, 16; CL: 99%) for conservatively treated patients. Ventilation therapy was related to prolonged LOS in surgically (OR: 2.2, 95% CI: 1.5–3.1;P<0.001) and conservatively treated patients (OR: 2.5, 95% CI: 2.2–2.9;P<0.001). Two or more in-hospital complications in surgical patients (OR: 2.7, 95% CI: 2.1–3.5) and ≥1 in conservative patients (OR: 3.0, 95% CI: 2.7–3.3) were predictors of prolonged LOS.Conclusion. The definition of prolonged LOS after ICH could be useful for several aspects of quality management and research. Preventing in-hospital complications could decrease the number of patients with prolonged LOS.

Download Full-text