Etiology, 3-Month Functional Outcome and Recurrent Events in Non-Traumatic Intracerebral Hemorrhage
출처 Journal of Stroke 2022; 24(2) : 266-277.
Published online : May 31, 2022
MethodsWe assessed prevalence of pre-specified ICH etiologies and their association with outcomes in consecutive ICH patients enrolled in the prospective Swiss Stroke Registry (2014 to 2019).ResultsWe included 2,650 patients (mean±standard deviation age 72±14 years, 46.5% female, median National Institutes of Health Stroke Scale 8 [interquartile range, 3 to 15]). Etiology was as follows: hypertension, 1,238 (46.7%); unknown, 566 (21.4%); antithrombotic therapy, 227 (8.6%); cerebral amyloid angiopathy (CAA), 217 (8.2%); macrovascular cause, 128 (4.8%); other determined etiology, 274 patients (10.3%). At 3 months, 880 patients (33.2%) were functionally independent and 664 had died (25.1%). ICH due to hypertension had a higher odds of functional independence (adjusted odds ratio [aOR], 1.33; 95% confidence interval [CI], 1.00 to 1.77; P=0.05) and lower mortality (aOR, 0.64; 95% CI, 0.47 to 0.86; P=0.003). ICH due to antithrombotic therapy had higher mortality (aOR, 1.62; 95% CI, 1.01 to 2.61; P=0.045). Within 3 months, 4.2% of patients had cerebrovascular events. The rate of ischemic stroke was higher than that of recurrent ICH in all etiologies but CAA and unknown etiology. CAA had high odds of recurrent ICH (aOR, 3.38; 95% CI, 1.48 to 7.69;P = 0.004) while the odds was lower in ICH due to hypertension (aOR, 0.42; 95% CI, 0.19 to 0.93;P = 0.031)
베른대 교수가 쓴 논문 스위스에서 ICH 환자를 분석한 2650명의 환자(여성 46.5%) NIHSS 8점의 원인은 고혈압 46.7%, 미상이 21.4%. 항혈전 치료 8.6%, 아밀로이드 병변이 8.2%, 대혈관이 원인이 4.8%, 기타 원인 10.3%.
3개월 후의 33.2%는 기능적으로 독립했다. 25.1%는 사망 고혈압이 원인이었던 경우가 기능적으로 회복될 확률이 높아 사망 확률이 낮다.
항혈전 치료가 원인일 경우 사망 확률이 높았다.
원인 미상 꽤 많다
Conclusions Although hype rtension is the leading etiology of ICH, other etiologies are frequent. One-third of ICH patients are functionally independent at 3 months. Except for patients with presumed CAA, the risk of is chemic stroke with in 3 months.
고혈압이 주된 원인이긴 하지만 다른 원인도 상당히 많다.비외상성 뇌출혈 환자의 1/3은 3개월 이내에 회복할 수 있다.