Journal article
Defining hematoma expansion in intracerebral hemorrhage Relationship with patient outcomes
D Dowlatshahi, AM Demchuk, ML Flaherty, M Ali, PL Lyden, EE Smith
NEUROLOGY | LIPPINCOTT WILLIAMS & WILKINS | Published : 2011
Abstract
BACKGROUND: Hematoma expansion (HE) is a surrogate marker in intracerebral hemorrhage (ICH) trials. However, the amount of HE necessary to produce poor outcomes in an individual is unclear; there is no agreement on a clinically meaningful definition of HE. We compared commonly used definitions of HE in their ability to predict poor outcome as defined by various cutpoints on the modified Rankin Scale (mRS). METHODS: In this cohort study, we analyzed 531 patients with ICH from the Virtual International Stroke Trials Archive. Primary outcome was mRS at 90 days, dichotomized into 0-3 vs 4-6. Secondary outcomes included other mRS cutpoints and mRS "shift analysis." Sensitivity, specificity, and p..
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Funding Acknowledgements
Dr. Dowlatshahi was supported by a Canadian Institutes of Health Research Fellowship award and a University of Ottawa Fellowship for New Faculty award. Dr. Demchuk has served on a scientific advisory board for Boehringer Ingelheim; has received funding for travel and speaker honoraria from Boehringer Ingelheim and Sanofi-Aventis; serves on the editorial boards of Journal of Neuroimaging, Stroke, and the International Journal of Stroke; and receives research support from Novo Nordisk and the NIH/NINDS. Dr. Flaherty has served as a consultant for Boehringer Ingelheim and receives research support from Novo Nordisk and the NIH/NINDS. Dr. Ali reports no disclosures. Dr. Lyden serves on a scientific advisory board for CoAxia, Inc.; has received funding for travel from Mitsubishi Tanabe Pharma Corporation and PhotoThera; serves on the editorial boards of Stroke, International Journal of Stroke, and Journal of Stroke and Cerebrovascular Disorders; receives publishing royalties for Thrombolytic Therapy for Acute Ischemic Stroke, 2<SUP>nd</SUP> ed. (Humana Press, 2006); serves as a consultant for Mitsubishi Tanabe Pharma Corporation, BeneChill, Inc., PhotoThera, CoAxia, Inc., Pfizer Inc., and ZZ Biotech L. L. C.; and has received research support from the NIH and the US Veterans Administration. Dr. Smith has served on a scientific advisory board for Genentech, Inc.; received speaker honoraria from the Canadian Conference on Dementia; serves as an Assistant Editor for Stroke; has served on speakers' bureaus for QuantiaMD and BMJ Best Practice; and receives research support from the NIH/NINDS, Canadian Institutes for Health Research, Canadian Stroke Network, a the Alberta Heritage Fund for Medical Research, and Hotchkiss Brain Institute.