scholarly journals Association Between Neck Circumference and Poor Outcome in Spontaneous Intracerebral Hemorrhage Patients: A Prospective Observational Study.

2020 ◽  
Author(s):  
Yujian Li ◽  
Huiqing Zhou ◽  
Xiang Yang ◽  
Jun Zheng ◽  
Fan Zhang ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Functional Outcome ◽  
Prospective Observational Study ◽  
Independent Predictor ◽  
Multivariate Logistic Regression Analysis ◽  
Neck Circumference ◽  
Roc Curve Analysis ◽  
Poor Functional Outcome ◽  
Poor Outcome

Abstract Background: Obesity is one of the major risk factors of intracerebral hemorrhage (ICH). Neck circumference (NC) is an indicator of obesity, and little is known about the role of NC in patients with ICH. This study aimed to assess the association between NC and functional outcome in ICH patients.Methods: We prospectively analyzed data of ICH patients who received treatment at our institution from January 2018 to November 2019. Patients were categorized as two groups according to 180-day Modified Rankin Scale (MRS) score. Univariate and multivariate analyses were performed to assess whether NC was associated with poor outcome in ICH patients. Receiver operating characteristic (ROC) curve analysis was performed to manifest the significance of NC in predicting the functional outcome of ICH patients.Results: A total of 312 patients were enrolled in our study. Multivariate logistic regression analysis indicated that NC was an independent predictor of 180-day poor functional outcome (odds ratio [OR] = 1.205, 95% confidence interval [CI]: 1.075-1.350, p = 0.001). ROC analysis revealed that NC could predict poor functional outcome at 6 months.Conclusion: NC is an independent predictor of unfavorable functional outcome at 6 months in ICH patients.

scholarly journals Neck Circumference Is Associated With Poor Outcome in Patients With Spontaneous Intracerebral Hemorrhage

2021 ◽  
Vol 11 ◽  
Author(s):  
Yujian Li ◽  
Huiqing Zhou ◽  
Xiang Yang ◽  
Jun Zheng ◽  
Fan Zhang ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Functional Outcome ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Independent Predictor ◽  
Multivariate Logistic Regression Analysis ◽  
Neck Circumference ◽  
Roc Curve Analysis ◽  
Poor Functional Outcome ◽  
Poor Outcome

Objective: This study aimed to assess the association between neck circumference (NC) and functional outcome in intracerebral hemorrhage (ICH) patients.Methods: We prospectively analyzed data from ICH patients who received treatment at our institution from January 2018 to November 2019. Patients were categorized into two groups according to 180-day modified Rankin scale (MRS) scores. Univariate and multivariate analyses were performed to assess whether NC was associated with poor outcome in ICH patients. Receiver operating characteristic (ROC) curve analysis was performed to determine the significance of NC in predicting the functional outcome of ICH patients.Results: A total of 312 patients were enrolled in our study. Multivariate logistic regression analysis indicated that NC was an independent predictor of poor 180-day functional outcome [odds ratio (OR) = 1.205, 95% confidence interval (CI): 1.075–1.350, p = 0.001]. ROC analysis revealed that NC could predict poor functional outcome at 6 months.Conclusions: NC is an independent predictor of unfavorable functional outcome at 6 months in ICH patients.

Black Hole Sign Predicts Poor Outcome in Patients with Intracerebral Hemorrhage

2018 ◽  
Vol 45 (1-2) ◽  
pp. 48-53 ◽  
Author(s):  
Qi Li ◽  
Wen-Song Yang ◽  
Sheng-Li Chen ◽  
Fu-Rong Lv ◽  
Fa-Jin Lv ◽  
...  
Keyword(s):  
Black Hole ◽  
Logistic Regression ◽  
Intracerebral Hemorrhage ◽  
Ct Scan ◽  
Functional Outcome ◽  
Multivariate Logistic Regression Analysis ◽  
Hematoma Expansion ◽  
Poor Functional Outcome ◽  
Poor Outcome ◽  
Prognostic Stratification

Background: In spontaneous intracerebral hemorrhage (ICH), black hole sign has been proposed as a promising imaging marker that predicts hematoma expansion in patients with ICH. The aim of our study was to investigate whether admission CT black hole sign predicts hematoma growth in patients with ICH. Methods: From July 2011 till February 2016, patients with spontaneous ICH who underwent baseline CT scan within 6 h of symptoms onset and follow-up CT scan were recruited into the study. The presence of black hole sign on admission non-enhanced CT was independently assessed by 2 readers. The functional outcome was assessed using the modified Rankin Scale (mRS) at 90 days. Univariate and multivariable logistic regression analyses were performed to assess the association between the presence of the black hole sign and functional outcome. Results: A total of 225 patients (67.6% male, mean age 60.3 years) were included in our study. Black hole sign was identified in 32 of 225 (14.2%) patients on admission CT scan. The multivariate logistic regression analysis demonstrated that age, intraventricular hemorrhage, baseline ICH volume, admission Glasgow Coma Scale score, and presence of black hole sign on baseline CT independently predict poor functional outcome at 90 days. There are significantly more patients with a poor functional outcome (defined as mRS ≥4) among patients with black hole sign than those without (84.4 vs. 32.1%, p < 0.001; OR 8.19, p = 0.001). Conclusions: The CT black hole sign independently predicts poor outcome in patients with ICH. Early identification of black hole sign is useful in prognostic stratification and may serve as a potential therapeutic target for anti-expansion clinical trials.

Satellite Sign: A Poor Outcome Predictor in Intracerebral Hemorrhage

2017 ◽  
Vol 44 (3-4) ◽  
pp. 105-112 ◽  
Author(s):  
Yoshiteru Shimoda ◽  
Satoru Ohtomo ◽  
Hiroaki Arai ◽  
Ken Okada ◽  
Teiji Tominaga
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Intracerebral Hemorrhage ◽  
Functional Outcome ◽  
Multivariate Logistic Regression Analysis ◽  
High Density ◽  
Multivariate Logistic Regression ◽  
Poor Functional Outcome ◽  
Poor Outcome ◽  
Intraventricular Bleeding

Background: The presence of high-density starry dots around the intracerebral hemorrhage (ICH), which we termed as a satellite sign, is occasionally observed in CT. The relationship between ICH with a satellite sign and its functional outcome has not been identified. This study aimed to determine whether the presence of a satellite sign could be an independent prognostic factor for patients with ICH. Methods: Patients with acute spontaneous ICH were retrospectively identified and their initial CT scans were reviewed. A satellite sign was defined as scattered high-density lesions completely separate from the main hemorrhage in at least the single axial slice. Functional outcome was evaluated using the modified Rankin Scale (mRS) at discharge. Poor functional outcome was defined as mRS scores of 3-6. Univariate and multivariate logistic regression analyses were applied to assess the presence of a satellite sign and its association with poor functional outcome. Results: A total of 241 patients with ICH were enrolled in the study. Of these, 98 (40.7%) had a satellite sign. Patients with a satellite sign had a significantly higher rate of poor functional outcome (95.9%) than those without a satellite sign (55.9%, p < 0.0001). Multivariate logistic regression analysis revealed that higher age (OR 1.06; 95% CI 1.03-1.10; p = 0.00016), large hemorrhage size (OR 1.06; 95% CI 1.03-1.11; p = 0.00015), and ICH with a satellite sign (OR 13.5; 95% CI 4.42-53.4; p < 0.0001) were significantly related to poor outcome. A satellite sign was significantly related with higher systolic blood pressure (p = 0.0014), higher diastolic blood pressure (p = 0.0117), shorter activated partial thromboplastin time (p = 0.0427), higher rate of intraventricular bleeding (p < 0.0001), and larger main hemorrhage (p < 0.0001). Conclusions: The presence of a satellite sign in the initial CT scan is associated with a significantly worse functional outcome in ICH patients.

scholarly journals Monocyte/High-Density Lipoprotein Ratio Predicts the Prognosis of Large Artery Atherosclerosis Ischemic Stroke

2021 ◽  
Vol 12 ◽  
Author(s):  
Youyu Li ◽  
Daqing Chen ◽  
Laifang Sun ◽  
Zhibo Chen ◽  
Weiwei Quan
Keyword(s):  
Ischemic Stroke ◽  
High Density Lipoprotein ◽  
Functional Outcome ◽  
Multivariate Logistic Regression Analysis ◽  
Density Lipoprotein ◽  
High Density ◽  
Large Artery ◽  
Poor Functional Outcome ◽  
Outcome Group ◽  
Increased Risk

Objective: Monocyte to high-density lipoprotein ratio is considered as a new inflammatory marker and has been used to predict the severity of coronary heart disease and the incidence of adverse cardiovascular events (ACEs). However, there is a lack of data relative to large artery atherosclerosis (LAA) ischemic stroke. We investigated whether the monocyte to high-density lipoprotein (HDL) ratio (MHR) is related to the 3-month functional prognosis of LAA ischemic stroke.Materials and Methods: A retrospective analysis was conducted on 316 LAA ischemic stroke patients. The 3-month functional outcome was divided into good and poor according to the modified Rankin Scale (mRS) score. Multivariate logistic regression analysis was performed to evaluate the correlation between MHR and prognosis of ischemic stroke.Results: The MHR level of poor functional outcome group was higher than that of the good functional outcome group [0.44 (0.3, 0.55) vs. 0.38 (0.27, 0.5), P = 0.025]. Logistic stepwise multiple regression revealed that MHR [odds ratio (OR) 9.464, 95%CI 2.257–39.678, P = 0.002] was an independent risk factor for the 3-month poor outcome of LAA ischemic stroke. Compared to the lower MHR tertile, the upper MHR tertile had a 3.03-fold increase (95% CI 1.475–6.225, P = 0.003) in the odds of poor functional outcome after adjustment for potential confounders. Moreover, a multivariable-adjusted restricted cubic spline (RCS) showed a positive close to a linear pattern of this association.Conclusion: Elevated MHR was independently associated with an increased risk of poor 3-month functional outcome of patients with LAA ischemic stroke.

Low ankle-brachial index is an independent predictor of poor functional outcome in acute cerebral infarction

2012 ◽  
Vol 224 (1) ◽  
pp. 113-117 ◽  
Author(s):  
Jinkwon Kim ◽  
Dong Hyun Lee ◽  
Myoung-Jin Cha ◽  
Tae-Jin Song ◽  
Ji Hye Park ◽  
...  
Keyword(s):  
Cerebral Infarction ◽  
Functional Outcome ◽  
Independent Predictor ◽  
Ankle Brachial Index ◽  
Acute Cerebral Infarction ◽  
Poor Functional Outcome

scholarly journals Decreased Time to Evacuation Improves Long Term Functional Outcome in Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Christopher P Kellner ◽  
Rui Song ◽  
Dominic A Nistal ◽  
Ian T McNeill ◽  
Hasitha M Samarage ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Intracerebral Hemorrhage ◽  
Functional Outcome ◽  
National Institutes Of Health ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Clinical Criteria ◽  
Poor Outcome ◽  
Deep Location

Abstract INTRODUCTION Preclinical and preliminary clinical data suggests that early minimally invasive intracerebral hemorrhage evacuation may convey a functional outcome benefit. Ongoing clinical trials permit an operative window extending out to 72 h. Here we present long term functional outcome after MIS endoscopic ICH evacuation with a focus on time to evacuation. METHODS Minimally invasive endoscopic ICH evacuation was performed on patients with supratentorial ICH who fit previously published clinical criteria including age = 18, National Institutes of Health Stroke Scale (NIHSS) = 6, hematoma volume = 15, and baseline modified Rankin Score (mRS) = 3 with a CTA negative for vascular malformation. Retrospective review was performed on patients who were treated in a single health system from December 2015 to August 2018. Demographic, clinical and radiographic previously demonstrated to impact ICH outcome were included in a multivariate logistic regression to identify factors predicting poor outcome (modified Rankin scale (mRS) 4-6) at 6 mo. RESULTS A total of 97 patients underwent minimally invasive endoscopic ICH evacuation. In a multivariate analysis, factors that predicted poor outcome included age (OR 1.81 (CI 1.15-3.08) P = .016), deep location (OR 11.1 (2.41-67.8) P = .004), presence of intraventricular hemorrhage (OR 5.81 (1.765-22.39) P = .006) and increased time to evacuation measured in hours (OR 1.048 (CI 1.017-1.084) P = .004). CONCLUSION Time to evacuation significantly impacts long term outcome in minimally invasive endoscopic ICH evacuation. Every minute counts.

Timing of clinical grade assessment and poor outcome in patients with aneurysmal subarachnoid hemorrhage

2012 ◽  
Vol 117 (1) ◽  
pp. 15-19 ◽  
Author(s):  
Elias A. Giraldo ◽  
Jay N. Mandrekar ◽  
Mark N. Rubin ◽  
Stefan A. Dupont ◽  
Yi Zhang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Subarachnoid Hemorrhage ◽  
Cerebral Infarction ◽  
Functional Outcome ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Intracerebral Hematoma ◽  
Poor Functional Outcome ◽  
Poor Outcome ◽  
Grade Assessment ◽  
Clinical Grading

Object Timing of clinical grading has not been fully studied in patients with aneurysmal subarachnoid hemorrhage (SAH). The primary objective of this study was to identify at which time point clinical assessment using the World Federation of Neurosurgical Societies (WFNS) grading scale and the Glasgow Coma Scale (GCS) is most predictive of poor functional outcome. Methods This study is a retrospective cohort study on the association between poor outcome and clinical grading determined at presentation, nadir, and postresuscitation. Poor functional outcome was defined as a Glasgow Outcome Scale score of 1–3 at 6 months after SAH. Results The authors identified 186 consecutive patients admitted to a teaching hospital between January 2002 and June 2008. The patients' mean age (± SD) was 56.9 ± 13.7 years, and 63% were women. Twenty-four percent had poor functional outcome (the mortality rate was 17%). On univariable logistic regression analyses, GCS score determined at presentation (OR 0.80, p < 0.0001), nadir (OR 0.73, p < 0.0001), and postresuscitation (OR 0.53, p < 0.0001); modified Fisher scale (OR 2.21, p = 0.0013); WFNS grade assessed at presentation (OR 1.92, p < 0.0001), nadir (OR 3.51, < 0.0001), and postresuscitation (OR 3.91, p < 0.0001); intracerebral hematoma on initial CT (OR 4.55, p < 0.0002); acute hydrocephalus (OR 2.29, p = 0.0375); and cerebral infarction (OR 4.84, p < 0.0001) were associated with poor outcome. On multivariable logistic regression analysis, only cerebral infarction (OR 5.80, p = 0.0013) and WFNS grade postresuscitation (OR 3.43, p < 0.0001) were associated with poor outcome. Receiver operating characteristic/area under the curve (AUC) analysis demonstrated that WFNS grade determined postresuscitation had a stronger association with poor outcome (AUC 0.90) than WFNS grade assessed upon admission or at nadir. Conclusions Timing of WFNS grade assessment affects its prognostic value. Outcome after aneurysmal SAH is best predicted by assessing WFNS grade after neurological resuscitation.

scholarly journals Role of Caregivers Training as Predictor of Outcome in Stroke Survivors – A Review

2014 ◽  
Vol 30 (1) ◽  
pp. 50-52
Author(s):  
Md Shahidur Rahman
Keyword(s):  
Home Care ◽  
Functional Outcome ◽  
Care Management ◽  
Hospital Costs ◽  
Early Discharge ◽  
Stroke Survivors ◽  
Poor Functional Outcome ◽  
Discharged Patients ◽  
Receive Treatment

There are many predictors of poor functional outcome in stroke survivors. Need of caregivers training to address the discharged patients for their home care management is often overlooked. Early discharge, lack of post-acute management facilities including home or community based services are other important predictors of poor functional outcome. Most of the patients are discharged home directly from hospital neurology unit after acute care management for inability to pay hospital costs. Rich patients who reside in the city can afford to receive treatment from trained nurse or physiotherapist at home but poor patients go home without any preparation for home care management of the patients. Hospital based rehabilitation management of stroke survivors are scarcely available in our country but thousands of inadequately treated patients are discharged home without any training to the caregivers. They come back to the outpatients department for next visit with multiple complications. This review article tried to find out the need and impact of caregivers training on outcome of stoke survivors. Bangladesh Journal of Neuroscience 2014; Vol. 30 (1): 50-52

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