Absolute risk and predictors of the growth of acute spontaneous intracerebral haemorrhage: a systematic review and meta-analysis of individual patient data

作者：Rustam Al‐Shahi Salman, Joseph Frantzias, Robert J. Lee, Patrick D. Lyden, Thomas W.K. Battey, Alison Ayres, Joshua N. Goldstein, Stephan A. Mayer, Thorsten Steiner, Xia Wang, Hisatomi Arima, Hitoshi Hasegawa, Makoto Oishi, Daniel A. Godoy, Luca Masotti, Dar Dowlatshahi, David Rodríguez‐Luna, Carlos A. Molina, Dong‐Kyu Jang, Antonio Dávalos, José Castillo, Xiaoying Yao, Jan Claassen, Bastian Volbers, Seiji Kazui, Yasushi Okada, Shigeru Fujimoto, Ḱazunori Toyoda, Qi Li, Jane Khoury, Pilar Delgado, José Álvarez‐Sabín, Mar Hernández‐Guillamón, Luís Prats‐Sánchez, Chunyan Cai, Mahesh Kate, Rebecca McCourt, Chitra Venkatasubramanian, Michael N. Diringer, Yukio Ikeda, Hans Worthmann, Wendy Ziai, Christopher D. d’Esterre, Richard I. Aviv, Peter Raab, Yasuo Murai, Allyson R. Zazulia, Kenneth Butcher, Seyed Mohammad Seyedsaadat, James C. Grotta, Joan Martí‐Fábregas, Joan Montaner, Joseph P. Broderick, Haruko Yamamoto, Dimitre Staykov, E. Sander Connolly, Magdy Selim, Rogelio Leira, Byung Hoo Moon, Andrew M. Demchuk, Mario Di Napoli, Yukihiko Fujii, Craig S Anderson, Jonathan Rosand, Daniel F. Hanley, Kenneth Butcher, Stephen M. Davis, Barbara Gregson, Kennedy R. Lees, Patrick D. Lyden, Stephan A. Mayer, Keith W. Muir, Thorsten Steiner, Peng Xie, Babak Bakhshayesh, Mark McDonald, Thomas G. Brott, Paolo Pennati, Adrian Parry‐Jones, Craig J Smith, Stephen J. Hopkins, Mark Slevin, Verónica Campi, Puneetpal Singh, Francesca Papa, Aurel Popa‐Wagner, V. Tudorica, Ryo Takagi, Akira Teramoto, Karin Weißenborn, Heinrich Lanfermann · 发表于：The Lancet Neurology · 年份：2018 · DOI：10.1016/s1474-4422(18)30253-9 · 被引用次数：431 · 研究领域：Intracerebral and Subarachnoid Hemorrhage Research、Acute Ischemic Stroke Management、Traumatic Brain Injury and Neurovascular Disturbances

BACKGROUND: Intracerebral haemorrhage growth is associated with poor clinical outcome and is a therapeutic target for improving outcome. We aimed to determine the absolute risk and predictors of intracerebral haemorrhage growth, develop and validate prediction models, and evaluate the added value of CT angiography. METHODS: In a systematic review of OVID MEDLINE-with additional hand-searching of relevant studies' bibliographies- from Jan 1, 1970, to Dec 31, 2015, we identified observational cohorts and randomised trials with repeat scanning protocols that included at least ten patients with acute intracerebral haemorrhage. We sought individual patient-level data from corresponding authors for patients aged 18 years or older with data available from brain imaging initially done 0·5-24 h and repeated fewer than 6 days after symptom onset, who had baseline intracerebral haemorrhage volume of less than 150 mL, and did not undergo acute treatment that might reduce intracerebral haemorrhage volume. We estimated the absolute risk and predictors of the primary outcome of intracerebral haemorrhage growth (defined as >6 mL increase in intracerebral haemorrhage volume on repeat imaging) using multivariable logistic regression models in development and validation cohorts in four subgroups of patients, using a hierarchical approach: patients not taking anticoagulant therapy at intracerebral haemorrhage onset (who constituted the largest subgroup), patients taking anticoagulant therapy at ...