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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Comparison of outcomes after intracerebral hemorrhage and ischemic stroke

David Chiu1, Leif Peterson1, Mitchell S V Elkind2

  • 1Methodist Neurological Institute, Weill Cornell Medical College, Houston, TX.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|May 4, 2010
PubMed

Insights

Intracerebral hemorrhage (ICH) nearly doubles the odds of long-term disability in stroke patients. However, ICH does not increase mortality risk compared to ischemic stroke when initial severity is considered.

Area of Science:

  • Neurology
  • Stroke Medicine
  • Clinical Research

Background:

  • Intracerebral hemorrhage (ICH) is linked to worse stroke outcomes than ischemic stroke.
  • Existing research suggests ICH may independently worsen prognosis.
  • This study investigates if ICH prognosis is independent of initial stroke severity.

Purpose of the Study:

  • To determine if intracerebral hemorrhage (ICH) independently predicts poorer neurologic outcomes.
  • To assess the impact of ICH on mortality compared to ischemic stroke, adjusting for stroke severity.

Main Methods:

  • Analysis of the Glycine Antagonist in Neuroprotection (GAIN) Americas trial data (1604 patients).
  • Compared outcomes for hemorrhagic (N=237) vs. ischemic (N=1367) stroke subtypes.
  • Used logistic and linear regression to analyze predictors of mortality and modified Rankin Scale (mRS) scores at 3 months, adjusting for NIH Stroke Scale and other factors.

Main Results:

  • ICH significantly increased odds of poor neurologic outcome (OR 1.94, 95% CI 1.23-3.06).
  • ICH was independently associated with a 0.25-point increase in 3-month mRS score (P=.04).
  • ICH did not significantly affect mortality compared to ischemic stroke after adjustments (OR 1.01, 95% CI .68-1.49).

Conclusions:

  • Intracerebral hemorrhage is an independent predictor of poor neurologic outcome in conscious stroke patients.
  • ICH nearly doubles the risk of long-term disability.
  • ICH is not associated with increased mortality risk compared to ischemic stroke when accounting for initial stroke severity.
Abstract

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