Abstract TP348: Predicting 365 Day Outcomes for Spontaneous Intracerebral Hemorrhage And Intraventricular Hemorrhage Survivors With Poor Outcome on Day 30

• Published in: Stroke (1970) 2018-01, Vol.49 (Suppl_1)
• Main Authors: Shah, Vishank A, Yenokyan, Gayane, Dlugash, Rachel, McBee, Nichol, Awad, Issam, Hanley, Daniel F, Ziai, Wendy C
• Format: Article
• Language: English
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/str.49.suppl_1.TP348

Abstract only Objective: Prediction of long-term functional outcome in spontaneous intracerebral and intraventricular hemorrhage (ICH/IVH) is typically based on a limited number of severity factors known on admission. We investigated whether factors known at day 30 including medical comorbidities and in-hospital events in poor outcome survivors could accurately predict good vs. poor functional outcome at day 365. Methods: We explored the relationship between ICH severity factors, medical comorbidities, prospectively collected and adjudicated events during first 30 days post ictus, and outcomes using data from the Clot Lysis: Evaluating Accelerated Resolution of Hemorrhage with Alteplase (CLEAR III) trial. We defined outcome using blinded assessment of mortality and modified Rankin scale (mRS) at 30 and 365 days (>3 signifying poor outcome). Multivariable logistic regression was used to predict mRS at day 365 from poor outcome survivors at day 30. Results: Of 500 patients included in CLEAR III with ICH and severe IVH requiring external ventricular drainage, 345 (69%) had mRS 4 or 5 on day 30. The best performing model for distinguishing between patients with and without good outcome at 365 days included: age (Odds Ratio [OR], 0.93; 95% Confidence Interval [CI], 0.90- 0.96), COPD (OR, 0.17; CI, 0.04-0.80), diabetes (OR, 0.50; CI, 0.25-0.98), hyperlipidemia (OR, 2.07; CI, 1.01-4.27), bacterial ventriculitis (OR, 0.34; CI, 0.13-0.91), cerebral perfusion pressure