Affiliations 

  • 1 Stroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, City Hospital, Nottingham, NG5 1PB, UK
  • 2 Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
  • 3 School of Medicine, University of Western Australia, Perth, Australia
  • 4 Stroke Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
  • 5 Department of Neurology, Selcuk University Medical Faculty, Konya, Turkey
  • 6 Department of Neurology, Semmelweis University, Budapest, Hungary
  • 7 Neurology Unit, Azienda Socio Sanitaria Territoriale di Mantova, Mantua, Italy
  • 8 Stroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, City Hospital, Nottingham, NG5 1PB, UK. nikola.sprigg@nottingham.ac.uk
Transl Stroke Res, 2020 Sep 09.
PMID: 32902808 DOI: 10.1007/s12975-020-00845-6

Abstract

Neurological deterioration is common after intracerebral hemorrhage (ICH). We aimed to identify the predictors and effects of neurological deterioration and whether tranexamic acid reduced the risk of neurological deterioration. Data from the Tranexamic acid in IntraCerebral Hemorrhage-2 (TICH-2) randomized controlled trial were analyzed. Neurological deterioration was defined as an increase in National Institutes of Health Stroke Scale (NIHSS) of ≥ 4 or a decline in Glasgow Coma Scale of ≥ 2. Neurological deterioration was considered to be early if it started ≤ 48 h and late if commenced between 48 h and 7 days after onset. Logistic regression was used to identify predictors and effects of neurological deterioration and the effect of tranexamic acid on neurological deterioration. Of 2325 patients, 735 (31.7%) had neurological deterioration: 590 (80.3%) occurred early and 145 (19.7%) late. Predictors of early neurological deterioration included recruitment from the UK, previous ICH, higher admission systolic blood pressure, higher NIHSS, shorter onset-to-CT time, larger baseline hematoma, intraventricular hemorrhage, subarachnoid extension and antiplatelet therapy. Older age, male sex, higher NIHSS, previous ICH and larger baseline hematoma predicted late neurological deterioration. Neurological deterioration was independently associated with a modified Rankin Scale of > 3 (aOR 4.98, 3.70-6.70; p 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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