02341nas a2200241   4500000000100000008004100001100001900042700001300061700001200074700001500086700001100101700001600112700001900128700001300147700001500160700001600175245008200191250001500273300001200288490000700300520174600307020004602053       2012                            d1 aArima Hisatomi1 aDavis S.1 aWang J.1 aParsons M.1 aLiu G.1 aHeeley Emma1 aAnderson Craig1 aHuang Y.1 aDelcourt C1 aChalmers J.00aHematoma growth and outcomes in intracerebral hemorrhage: The INTERACT1 study  a2012/06/30  a314-3190 v793 a<p>
OBJECTIVE: Uncertainty exists over the size of potential beneficial effects of medical treatments targeting hematoma growth in intracerebral hemorrhage (ICH). We report associations of hematoma growth parameters on clinical outcomes in the pilot phase, Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT1) (ClinicalTrials.gov NCT00226096). METHODS: In randomized patients with both baseline and 24-hour brain CT (n = 335), associations between measures of absolute and relative hematoma growth and 90-day poor outcomes of death and dependency (modified Rankin Scale score 3-5) were assessed in logistic regression models, with data reported as odds ratios (OR) and 95% confidence intervals (CI). RESULTS: A total of 10.7 mL (1 SD) increase in hematoma volume over 24 hours was strongly associated with poor outcome (adjusted OR 1.72, 95% CI 1.19-2.49; p = 0.004). An association was also evident for relative growth (adjusted OR 1.67, 95% 1.22-2.27; p = 0.001 for 1 SD increase). The analyses were adjusted for age, sex, achieved systolic blood pressure, elevated NIH Stroke Scale score (&gt;/=14), hematoma location, baseline hematoma volume, intraventricular extension, antithrombotic therapy, baseline glucose, time from ICH to baseline CT scan, and time from baseline to repeat CT scan. A 1 mL increase in hematoma growth was associated with a 5% (95% CI 2%-9%) higher risk of death or dependency. CONCLUSION: Medical treatments, such as rapid intensive blood pressure lowering, could achieve approximately 2-4 mL absolute attenuation of hematoma growth. There is hope that this could translate into modest but still clinically worthwhile ( approximately 10%-20% better chance) outcome from ICH.
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