Clinical characteristics and outcomes of intracerebral haemorrhage in young vs older adults: insights from the INTERACT3 trial

作者：Maria Khan, Menglu Ouyang, Mohammad Wasay, Lu Ma, X X Hu, Xiaoying Chen, Laurent Billot, Qiang Li, Paula Muñoz Venturelli, Asita de Silva, Nguyen Huy Thang, Kolawole Wahab, Jeyaraj Pandian, Octávio Marques Pontes‐Neto, Carlos Abanto, Antonio Arauz, Chao You, Lili Song, Craig S. Anderson, for the INTERACT3 Investigators, Thompson Robinson, J Jaime Miranda, Craig S Anderson, Chao You, Lili Song, Adrian Parry-Jones, Nikola Sprigg, S. F. Durrans, Caroline Harris, Ann Bamford, Olivia Smith · 发表于：European Stroke Journal · 年份：2026 · DOI：10.1093/esj/aakag040 · 研究领域：Intracerebral and Subarachnoid Hemorrhage Research、Acute Ischemic Stroke Management、Neurosurgical Procedures and Complications

INTRODUCTION: ICH is a severe form of stroke with increasing global burden. Although more common in older adults, ICH in younger individuals (≤50 years) is a clinically distinct but understudied subgroup. This secondary analysis of the INTERACT3 trial compared baseline characteristics, management and outcomes between younger and older ICH patients. PATIENTS AND METHODS: INTERACT3 was a stepped-wedge, cluster-randomised trial conducted in 122 hospitals across 10 countries (2017-2021), evaluating a bundled care intervention for acute ICH. This sub-study analysed 7031 patients and compared demographics, imaging features, in-hospital treatment and 6-month outcomes between age groups. Primary outcomes were functional status (mRS), mortality and quality of life (EQ-5D-3L). Outcomes were analysed using generalised linear-mixed models accounting for clustering by hospital (random effect) and fixed effects for time period and cluster treatment assignment, with additional adjustment for pre-specified patient-level covariates. RESULTS: Of 7031 patients, 1351 (19.2%) were aged ≤ 50 years. Younger patients were more often male (70.8% vs 62.4%, P < .0001), had higher body mass index (BMI) (25.3 vs 23.8 kg/m2, P < .0001) and were more likely to smoke (36.1% vs 21.4%) and consume alcohol (33.2% vs 13.3%). Despite having slightly larger haematoma volumes (18.0 vs 15.0 mL, P < .0001), younger patients had significantly better outcomes, with lower 6-month mortality (9.1% vs 16.6%; adjusted OR 0...