دورية أكاديمية
Spot sign score is associated with hematoma expansion and longer hospital stay but not functional outcomes in primary intracerebral hemorrhage survivors.
| العنوان: | Spot sign score is associated with hematoma expansion and longer hospital stay but not functional outcomes in primary intracerebral hemorrhage survivors. |
|---|---|
| المؤلفون: | Tseng WC; Department of Physical Medicine and Rehabilitation, Yunlin Rd, National Taiwan University Hospital Yunlin Branch, Yunlin County, Sec. 2, 579, Douliu City, Taiwan., Wang YF; Department of Medical Imaging, National Taiwan University Hospital, 7, Zhongshan S. Rd, Taipei, Taiwan., Chen HS; Department of Physical Medicine and Rehabilitation, Yunlin Rd, National Taiwan University Hospital Yunlin Branch, Yunlin County, Sec. 2, 579, Douliu City, Taiwan., Wang TG; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, 7, Zhongshan S. Rd, Taipei, Taiwan.; Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, 7, Zhongshan S. Rd, Taipei, Taiwan., Hsiao MY; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, 7, Zhongshan S. Rd, Taipei, Taiwan. myhsiao@ntu.edu.tw.; Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, 7, Zhongshan S. Rd, Taipei, Taiwan. myhsiao@ntu.edu.tw. |
| المصدر: | Japanese journal of radiology [Jpn J Radiol] 2024 Jun 04. Date of Electronic Publication: 2024 Jun 04. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: Japan NLM ID: 101490689 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1867-108X (Electronic) Linking ISSN: 18671071 NLM ISO Abbreviation: Jpn J Radiol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Tokyo : Springer |
| مستخلص: | Purpose: The computed tomography angiography (CTA) spot sign is a validated predictor of 30-day mortality in intracerebral hemorrhage (ICH). However, its role in predicting unfavorable functional outcomes remains unclear. This study explores the frequency of the spot sign and its association with functional outcomes, hematoma expansion, and length of hospital stay among survivors of ICH. Materials and Methods: This was a retrospective analysis of consecutive patients with primary ICH who received CTA within 24 h of admission to two medical centers between January 2007 and August 2022. Patients who died before discharge and those referred from other hospitals were excluded. Spot signs were assessed by an experienced neuroradiologist. Functional outcomes were determined by modified Rankin Scale (mRS) scores and the Barthel Index (BI). Results: In total, 98 patients were included; 14 (13.64%) had a spot sign. No significant differences were observed in the baseline characteristics between the patients with and without a spot sign. Higher spot sign scores were associated with higher odds of experiencing hematoma expansion (p = 0.013, 95% CI = 1.16-3.55), undergoing surgery (p = 0.012, 95% CI = 0.19-1.55), and having longer hospital stay (p = 0.02, 95% CI = 1.22-13.92). However, higher spot sign scores were not associated with unfavorable functional outcomes (p = 0.918 for BI, and p = 0.782 for mRS). Conclusion: Spot signs are common findings among patients with ICH, and higher spot sign scores were associated with subsequent hematoma expansion and longer hospital stays but not unfavorable functional outcomes. (© 2024. The Author(s) under exclusive licence to Japan Radiological Society.) |
| References: | Feigin VL, Lawes CM, Bennett DA, Barker-Collo SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. The Lancet Neurology. 2009;8(4):355–69. (PMID: 10.1016/S1474-4422(09)70025-019233729) D Rajashekar JW Liang 2023 Intracerebral Hemorrhage. StatPearls. Treasure Island (FL) ineligible companies. Disclosure: John Liang declares no relevant financial relationships with ineligible companies StatPearls Publishing. Fernando SM, Qureshi D, Talarico R, Tanuseputro P, Dowlatshahi D, Sood MM, et al. Intracerebral hemorrhage incidence, mortality, and association with oral anticoagulation use: a population study. Stroke. 2021;52(5):1673–81. (PMID: 10.1161/STROKEAHA.120.03255033685222) Feigin VL, Krishnamurthi RV, Parmar P, Norrving B, Mensah GA, Bennett DA, et al. Update on the global burden of ischemic and hemorrhagic stroke in 1990–2013: The GBD 2013 study. Neuroepidemiology. 2015;45(3):161–76. (PMID: 10.1159/00044108526505981) Samarasekera N, Fonville A, Lerpiniere C, Farrall AJ, Wardlaw JM, White PM, et al. Influence of intracerebral hemorrhage location on incidence, characteristics, and outcome: population-based study. Stroke. 2015;46(2):361–8. (PMID: 10.1161/STROKEAHA.114.00795325586833) Øie LR, Madsbu MA, Solheim O, Jakola AS, Giannadakis C, Vorhaug A, et al. Functional outcome and survival following spontaneous intracerebral hemorrhage: A retrospective population-based study. Brain Behav. 2018;8(10): e01113. (PMID: 10.1002/brb3.1113302401646192392) Becker KJ, Baxter AB, Bybee HM, Tirschwell DL, Abouelsaad T, Cohen WA. Extravasation of radiographic contrast is an independent predictor of death in primary intracerebral hemorrhage. Stroke. 1999;30(10):2025–32. (PMID: 10.1161/01.STR.30.10.202510512902) Delgado Almandoz JE, Yoo AJ, Stone MJ, Schaefer PW, Goldstein JN, Rosand J, et al. Systematic characterization of the computed tomography angiography spot sign in primary intracerebral hemorrhage identifies patients at highest risk for hematoma expansion: the spot sign score. Stroke. 2009;40(9):2994–3000. (PMID: 10.1161/STROKEAHA.109.554667195745533498504) Delgado Almandoz JE, Yoo AJ, Stone MJ, Schaefer PW, Oleinik A, Brouwers HB, et al. The spot sign score in primary intracerebral hemorrhage identifies patients at highest risk of in-hospital mortality and poor outcome among survivors. Stroke. 2010;41(1):54–60. (PMID: 10.1161/STROKEAHA.109.56538219910545) Demchuk AM, Dowlatshahi D, Rodriguez-Luna D, Molina CA, Blas YS, Dzialowski I, et al. Prediction of haematoma growth and outcome in patients with intracerebral haemorrhage using the CT-angiography spot sign (PREDICT): a prospective observational study. The Lancet Neurology. 2012;11(4):307–14. (PMID: 10.1016/S1474-4422(12)70038-822405630) Havsteen I, Ovesen C, Christensen AF, Hansen CK, Nielsen JK, Christensen H. Showing no spot sign is a strong predictor of independent living after intracerebral haemorrhage. Cerebrovascular diseases (Basel, Switzerland). 2014;37(3):164–70. (PMID: 10.1159/00035739724525481) Singh SD, Pasi M, Schreuder F, Morotti A, Senff JR, Warren AD, et al. Computed tomography angiography spot sign, hematoma expansion, and functional outcome in spontaneous cerebellar intracerebral hemorrhage. Stroke. 2021;52(9):2902–9. (PMID: 10.1161/STROKEAHA.120.03329734126759) Wada R, Aviv RI, Fox AJ, Sahlas DJ, Gladstone DJ, Tomlinson G, et al. CT angiography “spot sign” predicts hematoma expansion in acute intracerebral hemorrhage. Stroke. 2007;38(4):1257–62. (PMID: 10.1161/01.STR.0000259633.59404.f317322083) Hallevi H, Abraham AT, Barreto AD, Grotta JC, Savitz SI. The spot sign in intracerebral hemorrhage: the importance of looking for contrast extravasation. Cerebrovascular diseases (Basel, Switzerland). 2010;29(3):217–20. (PMID: 10.1159/00026784220029193) Falcone JA, Lopez A, Stradling D, Yu W, Chen JW. Blood pressure and spot sign in spontaneous supratentorial subcortical intracerebral hemorrhage. Neurocrit Care. 2022;37(1):246–54. (PMID: 10.1007/s12028-022-01485-4354459349283165) Miki K, Yagi K, Nonaka M, Iwaasa M, Abe H, Morishita T, et al. Spot sign as a predictor of rebleeding after endoscopic surgery for intracerebral hemorrhage. J Neurosurg. 2018;130(5):1–6. Meretoja A, Churilov L, Campbell BC, Aviv RI, Yassi N, Barras C, et al. The spot sign and tranexamic acid on preventing ICH growth–AUStralasia Trial (STOP-AUST): protocol of a phase II randomized, placebo-controlled, double-blind, multicenter trial. International journal of stroke: official journal of the International Stroke Society. 2014;9(4):519–24. (PMID: 10.1111/ijs.1213223981692) Gladstone DJ, Aviv RI, Demchuk AM, Hill MD, Thorpe KE, Khoury JC, et al. Effect of recombinant activated coagulation factor VII on hemorrhage expansion among patients with spot sign-positive acute intracerebral hemorrhage: the SPOTLIGHT and STOP-IT randomized clinical trials. JAMA Neurol. 2019;76(12):1493–501. (PMID: 10.1001/jamaneurol.2019.2636314244916704754) Meretoja A, Yassi N, Wu TY, Churilov L, Sibolt G, Jeng JS, et al. Tranexamic acid in patients with intracerebral haemorrhage (STOP-AUST): a multicentre, randomised, placebo-controlled, phase 2 trial. The Lancet Neurology. 2020;19(12):980–7. (PMID: 10.1016/S1474-4422(20)30369-033128912) Romero JM, Heit JJ, Delgado Almandoz JE, Goldstein JN, Lu J, Halpern E, et al. Spot sign score predicts rapid bleeding in spontaneous intracerebral hemorrhage. Emerg Radiol. 2012;19(3):195–202. (PMID: 10.1007/s10140-012-1020-9222713624318560) Tseng WC, Wang YF, Wang TG, Hsiao MY. Early spot sign is associated with functional outcomes in primary intracerebral hemorrhage survivors. BMC Neurol. 2021;21(1):131. (PMID: 10.1186/s12883-021-02146-3337436397980675) Ferrete-Araujo AM, Egea-Guerrero JJ, Vilches-Arenas A, Godoy DA, Murillo-Cabezas F. Predictors of mortality and poor functional outcome in severe spontaneous intracerebral hemorrhage: a prospective observational study. Med Intensiva. 2015;39(7):422–32. (PMID: 10.1016/j.medin.2014.10.00825499725) Marshall IJ, Wang Y, Crichton S, McKevitt C, Rudd AG, Wolfe CD. The effects of socioeconomic status on stroke risk and outcomes. The Lancet Neurology. 2015;14(12):1206–18. (PMID: 10.1016/S1474-4422(15)00200-826581971) Addo J, Ayerbe L, Mohan KM, Crichton S, Sheldenkar A, Chen R, et al. Socioeconomic status and stroke: an updated review. Stroke. 2012;43(4):1186–91. (PMID: 10.1161/STROKEAHA.111.63973222363052) de Oliveira Manoel AL. Surgery for spontaneous intracerebral hemorrhage. Critical care (London, England). 2020;24(1):45. (PMID: 10.1186/s13054-020-2749-232033578) Toh HJ, Lim ZY, Yap P, Tang T. Factors associated with prolonged length of stay in older patients. Singapore Med J. 2017;58(3):134–8. (PMID: 10.11622/smedj.2016158276095075360868) Marfil-Garza BA, Belaunzaran-Zamudio PF, Gulias-Herrero A, Zuniga AC, Caro-Vega Y, Kershenobich-Stalnikowitz D, et al. Risk factors associated with prolonged hospital length-of-stay: 18-year retrospective study of hospitalizations in a tertiary healthcare center in Mexico. PLoS ONE. 2018;13(11): e0207203. (PMID: 10.1371/journal.pone.0207203304081186224124) Shayne M, Culakova E, Poniewierski MS, Dale DC, Crawford J, Wogu AF, et al. Risk factors for in-hospital mortality and prolonged length of stay in older patients with solid tumor malignancies. Journal of geriatric oncology. 2013;4(4):310–8. (PMID: 10.1016/j.jgo.2013.05.00524472473) |
| معلومات مُعتمدة: | #112-N001 National Taiwan University Hospital Yunlin Branch |
| فهرسة مساهمة: | Keywords: Functional outcome; Intracerebral hemorrhage; Prognosis; Spot sign; Survivors |
| تواريخ الأحداث: | Date Created: 20240604 Latest Revision: 20240604 |
| رمز التحديث: | 20240604 |
| DOI: | 10.1007/s11604-024-01597-1 |
| PMID: | 38833105 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1867-108X |
|---|---|
| DOI: | 10.1007/s11604-024-01597-1 |