naa a22 4500 51079954X CHVBK 20180411083348.0 cr unu---uuuuu 180411e20131201xx s 000 0 eng 10.1007/s12028-013-9894-2 doi (NATIONALLICENCE)springer-10.1007/s12028-013-9894-2 Predictors of Late Neurological Deterioration After Spontaneous Intracerebral Hemorrhage [Elektronische Daten] [Weiping Sun, Wenqin Pan, Peter Kranz, Claire Hailey, Rachel Williamson, Wei Sun, Daniel Laskowitz, Michael James] Background: Although intracerebral hemorrhage (ICH) is a common form of cerebrovascular disease, little is known about factors leading to neurological deterioration occurring beyond 48h after hematoma formation. The purpose of this study was to characterize the incidence, consequences, and associative factors of late neurological deterioration (LND) in patients with spontaneous ICH. Methods: Using the Duke University Hospital Neuroscience Intensive Care Unit database from July 2007 to June 2012, a cohort of 149 consecutive patients with spontaneous supratentorial ICH met criteria for analysis. LND was defined as a decrease of two or more points in Glasgow Coma Scale score or death during the period from 48h to 1week after ICH symptom onset. Unfavorable outcome was defined as a modified Rankin Scale score of >2 at discharge. Results: Forty-three subjects (28.9%) developed LND. Logistic regression models revealed hematoma volume (OR=1.017, 95% CI 1.003-1.032, p=0.019), intraventricular hemorrhage (OR=2.519, 95% CI 1.142-5.554, p=0.022) and serum glucose on admission (OR=2.614, 95% CI 1.146-5.965, p=0.022) as independent predictors of LND. After adjusting for ICH score, LND was independently associated with unfavorable outcome (OR=4.000, 95% CI 1.280-12.500, p=0.017). In 65 subjects with follow-up computed tomography images, an increase in midline shift, as a surrogate for cerebral edema, was independently associated with LND (OR=3.822, 95% CI 1.157-12.622, p=0.028). Conclusions: LND is a common phenomenon in patients with ICH; further, LND appears to affect outcome. Independent predictors of LND include hematoma volume, intraventricular hemorrhage, and blood glucose on admission. Progression of perihematomal edema may be one mechanism for LND. Springer Science+Business Media New York, 2013 Intracerebral hemorrhage nationallicence Neurological deterioration nationallicence Predictors nationallicence Outcome nationallicence Brain edema nationallicence Sun Weiping Duke Clinical Research Institute, Duke University, Durham, NC, USA aut Pan Wenqin Duke Clinical Research Institute, Duke University, Durham, NC, USA aut Kranz Peter Department of Radiology (Neuroradiology), Duke University, Durham, NC, USA aut Hailey Claire Department of Anesthesiology, Duke University, DUMC-3094, 27710, Durham, NC, USA aut Williamson Rachel Department of Anesthesiology, Duke University, DUMC-3094, 27710, Durham, NC, USA aut Sun Wei Department of Neurology, Peking University First Hospital, Beijing, People's Republic of China aut Laskowitz Daniel Duke Clinical Research Institute, Duke University, Durham, NC, USA aut James Michael Department of Anesthesiology, Duke University, DUMC-3094, 27710, Durham, NC, USA aut Neurocritical Care Springer US; http://www.springer-ny.com 19/3(2013-12-01), 299-305 1541-6933 19:3<299 2013 19 12028 https://doi.org/10.1007/s12028-013-9894-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-013-9894-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sun Weiping Duke Clinical Research Institute, Duke University, Durham, NC, USA aut NATIONALLICENCE 700 1- Pan Wenqin Duke Clinical Research Institute, Duke University, Durham, NC, USA aut NATIONALLICENCE 700 1- Kranz Peter Department of Radiology (Neuroradiology), Duke University, Durham, NC, USA aut NATIONALLICENCE 700 1- Hailey Claire Department of Anesthesiology, Duke University, DUMC-3094, 27710, Durham, NC, USA aut NATIONALLICENCE 700 1- Williamson Rachel Department of Anesthesiology, Duke University, DUMC-3094, 27710, Durham, NC, USA aut NATIONALLICENCE 700 1- Sun Wei Department of Neurology, Peking University First Hospital, Beijing, People's Republic of China aut NATIONALLICENCE 700 1- Laskowitz Daniel Duke Clinical Research Institute, Duke University, Durham, NC, USA aut NATIONALLICENCE 700 1- James Michael Department of Anesthesiology, Duke University, DUMC-3094, 27710, Durham, NC, USA aut NATIONALLICENCE 773 0- Neurocritical Care Springer US; http://www.springer-ny.com 19/3(2013-12-01), 299-305 1541-6933 19:3<299 2013 19 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer