Document Detail


Prior statin use reduces mortality in intracerebral hemorrhage.
MedLine Citation:
PMID:  17701108     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the impact of blood glucose, coagulopathy, seizures and prior statin and aspirin use on clinical outcome following intracerebral hemorrhage (ICH). BACKGROUND: Intracerebral hemorrhage (ICH) accounts for 10-15% of all strokes with mortality rates approaching 50%. Glasgow Coma Scale (GCS), ICH volume, age, pulse pressure, ICH location, intraventricular hemorrhage (IVH) and hydrocephalus are known to impact 30-day survival following ICH and are included in various prediction models. The role of other clinical variables in the long-term outcome of these patients is less clear. METHODS: Records of consecutive ICH patients admitted to The Johns Hopkins Hospital from 1999 to 2006 were reviewed. Patients with ICH related to trauma or underlying lesions (e.g. brain tumors, aneurysms, arterio-venous malformations) and of infratentorial location were excluded. The impact of admission blood glucose, coagulopathy, seizures on presentation and prior statin and aspirin use on 30-day mortality and functional outcomes at discharge was assessed using dichotomized Modified Rankin Scale (dMRS) and Glasgow Outcomes scale (dGOS). Other variables known to impact outcomes that were included in the multiple logistic regression analysis were age, admission GCS, pulse pressure, ICH volume, ICH location, volume of IVH and hydrocephalus. RESULTS: A total of 314 patients with ICH were identified, 125 met inclusion criteria. Patients' age ranged from 34 to 90 years (mean 63.5), 57.6 % were male. Mean ICH volume was 32.09 cc (range 1-214 cc). Following multiple logistic regression analysis, prior statin use (P = 0.05) was found to be associated with decreased mortality with a greater than 12-fold odds of survival while admission blood glucose (P = 0.023) was associated with increased 30-day mortality. Coagulopathy, seizures on presentation, and prior aspirin use had no significant impact on 30-day mortality or outcomes at discharge in our study cohort. CONCLUSIONS: The significant association of prior statin use with decreased mortality warrants prospective evaluation of the use of statins following ICH.
Authors:
Neeraj S Naval; Tamer A Abdelhak; Paloma Zeballos; Nathalie Urrunaga; Marek A Mirski; Juan R Carhuapoma
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurocritical care     Volume:  8     ISSN:  1541-6933     ISO Abbreviation:  Neurocrit Care     Publication Date:  2008  
Date Detail:
Created Date:  2008-01-08     Completed Date:  2008-04-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101156086     Medline TA:  Neurocrit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  6-12     Citation Subset:  IM    
Affiliation:
The Johns Hopkins Hospital, Baltimore, MD, USA. nnaval1@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Blood Coagulation Disorders / mortality
Blood Glucose
Cerebral Hemorrhage / drug therapy*,  mortality*
Epilepsy / mortality
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
Male
Middle Aged
Recovery of Function
Retrospective Studies
Stroke / drug therapy*,  mortality*
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors
Comments/Corrections
Comment In:
Neurocrit Care. 2008;8(1):3-5   [PMID:  18094941 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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