Noncontrast computed tomography signs as predictors of hematoma expansion, clinical outcome, and response to tranexamic acid in acute intracerebral hemorrhage

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dc.contributor.authorLaw, Zhe Kang.
dc.contributor.authorAli, Azlinawati.
dc.contributor.authorKrishnan, Kailash.
dc.contributor.authorBischoff, Adam.
dc.contributor.authorAppleton, Jason P.
dc.contributor.authorScutt, Polly.
dc.contributor.authorWoodhouse, Lisa.
dc.contributor.authorPszczolkowski, Stefan.
dc.contributor.authorCala, Lesley A.
dc.contributor.authorDineen, Robert A.
dc.contributor.authorEngland, Timothy J.
dc.contributor.authorOzturk, Serefnur.
dc.contributor.authorRoffe, Christine.
dc.contributor.authorBereczki, Daniel.
dc.contributor.authorCiccone, Alfonso.
dc.contributor.authorChristensen, Hanne.
dc.contributor.authorOvesen, Christian.
dc.contributor.authorBath, Philip M.
dc.contributor.authorSprigg, Nikola.
dc.date.accessioned2020-03-26T20:20:23Z
dc.date.available2020-03-26T20:20:23Z
dc.date.issued2020
dc.departmentSelçuk Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümüen_US
dc.description.abstractBackground and Purpose- Blend, black hole, island signs, and hypodensities are reported to predict hematoma expansion in acute intracerebral hemorrhage. We explored the value of these noncontrast computed tomography signs in predicting hematoma expansion and functional outcome in our cohort of intracerebral hemorrhage. Methods- The TICH-2 (Tranexamic acid for IntraCerebral Hemorrhage-2) was a prospective randomized controlled trial exploring the efficacy and safety of tranexamic acid in acute intracerebral hemorrhage. Baseline and 24-hour computed tomography scans of trial participants were analyzed. Hematoma expansion was defined as an increase in hematoma volume of >33% or >6 mL on 24-hour computed tomography. Poor functional outcome was defined as modified Rankin Scale of 4 to 6 at day 90. Multivariable logistic regression was performed to identify predictors of hematoma expansion and poor functional outcome. Results- Of 2325 patients recruited, 2077 (89.3%) had valid baseline and 24-hour scans. Five hundred seventy patients (27.4%) had hematoma expansion while 1259 patients (54.6%) had poor functional outcome. The prevalence of noncontrast computed tomography signs was blend sign, 366 (16.1%); black hole sign, 414 (18.2%); island sign, 200 (8.8%); and hypodensities, 701 (30.2%). Blend sign (adjusted odds ratio [aOR] 1.53 [95% CI, 1.16-2.03]; P=0.003), black hole (aOR, 2.03 [1.34-3.08]; P=0.001), and hypodensities (aOR, 2.06 [1.48-2.89]; P<0.001) were independent predictors of hematoma expansion on multivariable analysis with adjustment for covariates. Black hole sign (aOR, 1.52 [1.10-2.11]; P=0.012), hypodensities (aOR, 1.37 [1.05-1.78]; P=0.019), and island sign (aOR, 2.59 [1.21-5.55]; P=0.014) were significant predictors of poor functional outcome. Tranexamic acid reduced the risk of hematoma expansion (aOR, 0.77 [0.63-0.94]; P=0.010), but there was no significant interaction between the presence of noncontrast computed tomography signs and benefit of tranexamic acid on hematoma expansion and functional outcome (P interaction all >0.05). Conclusions- Blend sign, black hole sign, and hypodensities predict hematoma expansion while black hole sign, hypodensities, and island signs predict poor functional outcome. Noncontrast computed tomography signs did not predict a better response to tranexamic acid.en_US
dc.description.sponsorshipNational Institute of Health Research Health Technology Assessment ProgrammeNational Institute for Health Research (NIHR) [11_129_109]; Swiss Heart Foundationen_US
dc.description.sponsorshipThis article was supported by National Institute of Health Research Health Technology Assessment Programme (11_129_109) and Swiss Heart Foundation.en_US
dc.identifier.citationLaw, Z. K., Ali, A., Krishnan, K., Bischoff, A., Appleton, J. P., Scutt, P., Woodhouse, L., Pszczolkowski, S., Cala, L. A., Dineen, R. A., England, T. J., Ozturk, S., Roffe, C., Bereczki, D., Ciccone, A., Christensen, H., Ovesen, C., Bath, P. M., Sprigg, N. (2020). Noncontrast Computed Tomography Signs as Predictors of Hematoma Expansion, Clinical Outcome, and Response to Tranexamic Acid in Acute Intracerebral Hemorrhage. Stroke, 55(1), 121-128.
dc.identifier.doi10.1161/STROKEAHA.119.026128en_US
dc.identifier.endpage128en_US
dc.identifier.issn0039-2499en_US
dc.identifier.issn1524-4628en_US
dc.identifier.issue1en_US
dc.identifier.pmid31735141en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage121en_US
dc.identifier.urihttps://dx.doi.org/10.1161/STROKEAHA.119.026128
dc.identifier.urihttps://hdl.handle.net/20.500.12395/38575
dc.identifier.volume51en_US
dc.identifier.wosWOS:000504225600032en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.institutionauthorOzturk, Serefnur.
dc.language.isoenen_US
dc.publisherLIPPINCOTT WILLIAMS & WILKINSen_US
dc.relation.ispartofSTROKEen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.selcuk20240510_oaigen_US
dc.subjectcerebral hemorrhageen_US
dc.subjecthematomaen_US
dc.subjectodds ratioen_US
dc.subjectprevalenceen_US
dc.subjectprobabilityen_US
dc.subjecttranexamic aciden_US
dc.titleNoncontrast computed tomography signs as predictors of hematoma expansion, clinical outcome, and response to tranexamic acid in acute intracerebral hemorrhageen_US
dc.typeArticleen_US

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