Marco Pasi1, Barbara Casolla1, Maéva Kyheng2, Grégoire Boulouis3,4, Grégory Kuchcinski3, Solène Moulin1, Julien Labreuche2, Hilde Hénon1, Charlotte Cordonnier1, Didier Leys1. 1. U1172 - LilNCog - Lille Neuroscience & Cognition, 27023University of Lille, Inserm, CHU Lille, Lille, France. 2. Department of Biostatics and Public Health, 27023University of Lille, EA 2694, CHU Lille, Lille, France. 3. Department of Neuroradiology, 27023University of Lille, Inserm U1171, CHU Lille, Lille, France. 4. Department of Neuroradiology, Paris-Descartes University, Inserm U894, Saint-Anne Hospital, Paris, France.
Abstract
BACKGROUND: Factors associated with long-term mortality after spontaneous intracerebral hemorrhage (ICH) have been poorly investigated. AIM: Our objective was to identify variables associated with long-term mortality in a prospective cohort of 30-day ICH survivors. METHODS: We prospectively included consecutive 30-day spontaneous ICH survivors. We evaluated baseline and follow-up clinical characteristics and magnetic resonance imaging (MRI) markers of chronic brain injury as variables associated with long-term mortality using univariate and multivariable Cox proportional hazard regression models. RESULTS: Of 560 patients with spontaneous ICH, 304 (54.2%) survived more than 30 days and consented for follow-up. During a median follow-up of 10 years (interquartile range: 8.0-10.5), 176 patients died. The cumulative survival rate at 10 years was 38%. In multivariable analysis, variables independently associated with long-term mortality were age (hazard ratio (HR) per 10-year increase: 1.68, 95% confidence interval (CI): 1.45-1.95), male gender (HR: 1.41, CI: 1.02-1.95), prestroke dependency (HR: 1.66, CI: 1.15-2.39), National Institutes of Health Stroke Scale score (HR per 1-point increase: 1.03, CI: 1.01-1.04), occurrence of any stroke (HR: 2.24, CI: 1.39-3.60), and dementia (HR: 1.51, CI: 1.06-2.16) during follow-up. Among MRI markers, only cerebral atrophy (HR per 1-point increase: 1.50, CI: 1.13-2.00) was independently associated with long-term mortality. CONCLUSIONS: Preexisting comorbidities, clinical severity at presentation, and significant clinical event during follow-up are associated with long-term mortality. Among MRI markers of chronic brain injury, only cerebral atrophy is associated with long-term mortality.
BACKGROUND: Factors associated with long-term mortality after spontaneous intracerebral hemorrhage (ICH) have been poorly investigated. AIM: Our objective was to identify variables associated with long-term mortality in a prospective cohort of 30-day ICH survivors. METHODS: We prospectively included consecutive 30-day spontaneous ICH survivors. We evaluated baseline and follow-up clinical characteristics and magnetic resonance imaging (MRI) markers of chronic brain injury as variables associated with long-term mortality using univariate and multivariable Cox proportional hazard regression models. RESULTS: Of 560 patients with spontaneous ICH, 304 (54.2%) survived more than 30 days and consented for follow-up. During a median follow-up of 10 years (interquartile range: 8.0-10.5), 176 patientsdied. The cumulative survival rate at 10 years was 38%. In multivariable analysis, variables independently associated with long-term mortality were age (hazard ratio (HR) per 10-year increase: 1.68, 95% confidence interval (CI): 1.45-1.95), male gender (HR: 1.41, CI: 1.02-1.95), prestroke dependency (HR: 1.66, CI: 1.15-2.39), National Institutes of Health Stroke Scale score (HR per 1-point increase: 1.03, CI: 1.01-1.04), occurrence of any stroke (HR: 2.24, CI: 1.39-3.60), and dementia (HR: 1.51, CI: 1.06-2.16) during follow-up. Among MRI markers, only cerebral atrophy (HR per 1-point increase: 1.50, CI: 1.13-2.00) was independently associated with long-term mortality. CONCLUSIONS: Preexisting comorbidities, clinical severity at presentation, and significant clinical event during follow-up are associated with long-term mortality. Among MRI markers of chronic brain injury, only cerebral atrophy is associated with long-term mortality.