Lobar intracerebral hemorrhage and risk of subsequent uncontrolled blood pressure

Myserlis, Evangelos Pavlos; Mayerhofer, Ernst; Abramson, Jessica R; Teo, Kay‐Cheong; Montgomery, Bailey; Sugita, Lansing; Warren, Andrew; Goldstein, Joshua N.; Gurol, M. Edip; Viswanathan, Anand; Greenberg, Steven M.; Biffi, Alessandro; Anderson, Christopher; Rosand, Jonathan

doi:10.1177/23969873221094412

Cited by 3 publications

(1 citation statement)

References 26 publications

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“…Studies showed that a minority of survivors achieved adequate BP control, with suboptimal BP control in more than 50% of ICH survivors 19,20 . Poor BP control might be explained by undertreatment ‐especially in lobar ICH survivors‐ or by resistant hypertension more often found in Black, Hispanic and Asian people 20,30 . There is limited evidence about the optimal antihypertensive drugs to use after ICH events.…”

Section: Blood Pressure Loweringmentioning

confidence: 99%

Secondary prevention after intracerebral haemorrhage

Toffali

Carbone

Fainardi

et al. 2023

Eur J Clin Investigation

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Background Intracerebral haemorrhage (ICH) has high mortality in the acute phase and poor functional outcome in the majority of survivors. ICH recurrence is a major determinant of long‐term prognosis and is the most feared complication of antithrombotic treatment. On the other hand, ICH patients are at high risk of future ischaemic vascular events. Methods This narrative review provides a critical analysis of the current knowledge on the topic. We performed a Pubmed search with the following terms ‘intracerebral haemorrhage’, ‘stroke’, ‘outcome’, ‘secondary prevention’, ‘anticoagulation’ and ‘atrial fibrillation’, including only English written studies with no time restrictions. Results Blood pressure management is the cornerstone of secondary ICH prevention, regardless of ICH location or underlying cerebral small vessel disease. Resumption of antiplatelet and anticoagulation therapy is often challenging, with limited evidence from randomized trials. Clinical and imaging predictors can inform the stratification of ICH recurrence risk and might identify patients at very high probability of future haemorrhagic events. This narrative review provides a summary of the main diagnostic tools and therapeutic strategies available for secondary prevention in ICH survivors. Conclusion Appropriate recognition and treatment of modifiable risk factors for ICH recurrence might improve outcomes in ICH survivors. Ongoing randomized trials might provide novel insights and improve long‐term management.

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Section: Blood Pressure Loweringmentioning

confidence: 99%

Secondary prevention after intracerebral haemorrhage

Toffali

Carbone

Fainardi

et al. 2023

Eur J Clin Investigation

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Subcortical hemorrhage caused by cerebral amyloid angiopathy compared with hypertensive hemorrhage

Yamada,

Tomita,

Iwamoto

et al. 2024

Clinical Neurology and Neurosurgery

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Development of a risk predication model for critical care needs in patients with intracerebral hemorrhage: a retrospective cohort

Wu,

Pan,

et al. 2024

BMC Nurs

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Background It is very important to provide the correct nursing care for patients with intracerebral hemorrhage (ICH), but the level of critical care needs in patients with intracerebral hemorrhage is not clear. The purpose of this study is to establish a risk model based on the epidemiological and clinical characteristics of ICH patients, to help identify the critical care needs of ICH patients. Methods The clinical data of ICH patients from January 2018 to September 2023 were analyzed retrospectively. The full cohort was used to derive the clinical prediction model and the model was internally validated with bootstrapping. Discrimination and calibration were assessed using the area under curve (AUC) and the Hosmer-Lemeshow tests, respectively. Results 611 patients with ICH were included for model development. 61.21% (374/611) ICH patients had received critical care interventions. The influencing factors included in the model were Glasgow Coma Scale (GCS) score, intraventricular hemorrhage, past blood pressure control, systolic blood pressure on admission and bleeding volume. The model’s goodness-of-fit was evaluated, which yielded a high area under the curve (AUC) value of 0.943, indicating a good fit. For the purpose of model validation, a cohort of 260 patients with ICH was utilized. The model demonstrated a Youden’s index of 0.750, with a sensitivity of 90.56% and a specificity of 78.22%. Conclusion GCS, systolic blood pressure, intraventricular hemorrhage, bleeding volume and past blood pressure control are the main factors affecting the critical care needs of patients with ICH. This study has deduced a clinical predictive model with good discrimination and calibration to provide scoring criteria for clinical health care providers to accurately evaluate and identify the critical care needs of ICH patients, to improve the rational integration and allocation of medical resources.

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Lobar intracerebral hemorrhage and risk of subsequent uncontrolled blood pressure

Cited by 3 publications

References 26 publications

Secondary prevention after intracerebral haemorrhage

Secondary prevention after intracerebral haemorrhage

Subcortical hemorrhage caused by cerebral amyloid angiopathy compared with hypertensive hemorrhage

Development of a risk predication model for critical care needs in patients with intracerebral hemorrhage: a retrospective cohort

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