Risk Factors and Long Term Outcome in Young Adults with Spontaneous Intracerebral Hemorrhage (P02.211)

Background and Purpose: Hemispheric location might influence outcome after intracerebral hemorrhage (ICH). INTERACT suggested higher short-term mortality in right hemispheric ICH, yet statistical imbalances were not addressed. This study aimed at determining the differences in long-term functional outcome in patients with right- vs. left-sided ICH with a priori-defined sub-analysis of lobar vs. deep bleedings. Methods: Data from a prospective hospital registry were analyzed including patients with ICH admitted between January 2006 and August 2014. Data were retrieved from institutional databases. Outcome was assessed using the modified Rankin Scale (mRS) score. Outcome measures (long-term mortality and functional outcome at 12 months) were correlated with ICH location and hemisphere, and the imbalances of baseline characteristics were addressed by propensity score matching. Results: A total of 831 patients with supratentorial ICH (429 left and 402 right) were analyzed. Regarding clinical baseline characteristics in the unadjusted overall cohort, there were differences in disfavor of right-sided ICH (antiplatelets: 25.2% in left ICH vs. 34.3% in right ICH; p < 0.01; previous ischemic stroke: 14.7% in left ICH vs. 19.7% in right ICH; p = 0.057; and presence/extent of intraventricular hemorrhage: 45.0% in left ICH vs. 53.0% in right ICH; p = 0.021; Graeb-score: 0 [0-4] in left ICH vs. 1 [0-5] in right ICH; p = 0.017). While there were no differences in mortality and in the proportion of patients with favorable vs. unfavorable outcome (mRS 0-3: 142/375 [37.9%] in left ICH vs. 117/362 [32.3%] in right ICH; p = 0.115), patients with left-sided ICH showed excellent outcome more frequently (mRS 0-1: 64/375 [17.1%] in left ICH vs. 43/362 [11.9%] in right ICH; p = 0.046) in the unadjusted analysis. After adjusting for confounding variables, a well-balanced group of patients (n = 360/hemisphere) was compared showing no differences in long-term functional outcome (mRS 0-3: 36.4% in left ICH vs. 33.9% in right ICH; p = 0.51). Sub-analyses of patients with deep vs. lobar ICH revealed also no differences in outcome measures (mRS 0-3: 53/151 [35.1%] in left deep ICH vs. 53/165 [32.1%] in right deep ICH; p = 0.58). Conclusion: Previously described differences in clinical end points among patients with left- vs. right-hemispheric ICH may be driven by different baseline characteristics rather than by functional deficits emerging from different hemispheric functions affected. After statistical corrections for confounding variables, there was no impact of hemispheric location on functional outcome after ICH.

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Long-term outcome of seizure-free patients and risk factors of relapse following antiepileptic drug withdrawal

Epilepsy & Behavior ◽

10.1016/j.yebeh.2018.09.028 ◽

2018 ◽

Vol 88 ◽

pp. 295-300 ◽

Cited By ~ 1

Author(s):

Shuchun Ou ◽

Lu Xia ◽

Rong Li ◽

Li Wang ◽

Li Xia ◽

...

Keyword(s):

Risk Factors ◽

Antiepileptic Drug ◽

Drug Withdrawal ◽

Term Outcome ◽

Long Term Outcome ◽

Antiepileptic Drug Withdrawal

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Clinical Characteristics, Short- and Long-term Outcome of Acute Coronary Syndrome in Young Adults

The American Journal of Cardiology ◽

10.1016/j.amjcard.2013.01.202 ◽

2013 ◽

Vol 111 (7) ◽

pp. 80B

Author(s):

Keiji Yamada ◽

Satoru Sakuragi ◽

Kota Okabe ◽

Takashi Fuziwara ◽

Takashi Miki ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Young Adults ◽

Clinical Characteristics ◽

Term Outcome ◽

Long Term Outcome ◽

Coronary Syndrome ◽

Short And Long Term

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Predictors for the Immediate and Long-Term Outcome of Avascular Surgical Procedure

Scandinavian Journal of Surgery ◽

10.1177/145749690909800307 ◽

2009 ◽

Vol 98 (3) ◽

pp. 164-168 ◽

Cited By ~ 4

Author(s):

J. Virkkunen ◽

M. Venermo ◽

J. Saarinen ◽

J. Salenius

Keyword(s):

Risk Factors ◽

Risk Factor ◽

High Risk ◽

Predictive Value ◽

Surgical Procedure ◽

Operative Mortality ◽

Survival Rates ◽

Term Outcome ◽

Long Term Outcome

Background and Aims: The ability to predict post-operative mortality reliably will be of assistance in making decisions concerning the treatment of an individual patient. The aim of this study was to test the GAS score as a predictor of post-operative mortality in vascular surgical patients. Material and Methods: A total of 157 consecutive patients who underwent an elective vascular surgical procedure were included in the study. The Cox proportional hazards model was used in analyzing the importance of various preoperative risk factors for the postoperative outcome. ASA and GAS were tested in predicting the short and long-term outcome. On the basis of the GAS cut-off value 77, patients were selected into low-risk (GAS low: GAS < 77) and high-risk (GAS high: GAS > = 77) groups, and the examined risk factors were analyzed to determine which of them had predictive value for the prognosis. Results: None of the patients in the GAS low group died, and mortality in the GAS high group was 4.8% (p = 0.03) at 30 days' follow-up. The 12-month survival rates were 98.6% and 78.6% (p = 0.0001), respectively, with the respective 5-year survival rates of 76.7% and 44.0% (p = 0.0001). The only independent risk factor for 30-day mortality was the renal risk factor (OR 20.2). The combination of all three GAS variables(chronic renal failure, cardiac disease and cerebrovascular disease), excluding age, was associated with a 100% two-year mortality. Conclusions: Mortality is low for patients with GAS<77. For the high-risk patients (GAS> = 77), due to its low predictive value for death, GAS yields limited value in clinical practice. In cases of patients with all three risk factors (renal, cardiac and cerebrovascular), vascular surgery should be considered very carefully.

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