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. 2023 Feb 2;5(1):5.
doi: 10.1186/s42466-023-00231-1.

The "SALPARE study" of spontaneous intracerebral hemorrhage: part 1

Ludovica De Rosa #  1 , Renzo Manara #  2 , Francesca Vodret  3 , Caterina Kulyk  4 , Florian Montano  5 , Alessio Pieroni  3 , Federica Viaro  3 , Maria Luisa Zedde  6 , Rosa Napoletano  7 , Mario Ermani  8 , Claudio Baracchini #  3
Affiliations

The "SALPARE study" of spontaneous intracerebral hemorrhage: part 1

Ludovica De Rosa et al. Neurol Res Pract. .

Abstract

Background: Spontaneous intracerebral hemorrhage (ICH) is a devastating type of stroke with a huge impact on patients and families. Expanded use of oral anticoagulants and ageing population might contribute to an epidemiological change. In view of these trends, we planned a study to obtain a contemporary picture and identify early prognostic factors to improve secondary prevention.

Methods: This multicenter prospective cohort study included consecutive adult patients with non-traumatic ICH admitted to three academic Italian hospitals (Salerno, Padova, Reggio Emilia) over a 2-year period. Demographic characteristics, vascular risk profile, clinical data and main radiological characteristics were correlated to 90-day clinical outcome.

Results: Out of 682 patients [mean age: 73 ± 14 years; 316 (46.3%) females] enrolled in this study, 40% died [86/180 (47.8%) in Salerno, 120/320 (37.5%) in Padova, 67/182 (36.8%) in Reggio Emilia; p < 0.05)] and 36% were severely disabled at 90 days. Several factors were associated with a higher risk of poor functional outcome such as antithrombotic drug use, hyperglycemia, previous cerebrovascular accident, low platelet count, and pontine/massive/intraventricular hemorrhage. However, at multivariate analysis only pre-ICH mRS score (OR 30.84), GCS score at presentation (OR 11.88), initial hematoma volume (OR 29.71), and NIHSS score at presentation (OR 25.89) were independent predictors of death and poor functional outcome.

Conclusion: Despite the heterogeneity among centers, this study on ICH has identified four simple prognostic factors that can independently predict patients outcome, stratify their risk, and guide their management.

Keywords: Anticoagulants; Cerebral hemorrhage; Hematoma; Predictors; Stroke.

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Conflict of interest statement

The authors report no relationships that could be construed as a conflict of interest.

Figures

Fig. 1
Fig. 1
Mortality and disability at 90 days from the index event
Fig. 2
Fig. 2
Survival rates (2016 vs. 2017) in the Padua cohort among deceased patients at 3 months
Fig. 3
Fig. 3
Three-month mortality and disability rates in anticoagulated versus non-anticoagulated patients, *p = 0.01
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