Associations Between Prehospital Physiological Parameters and Functional Outcome in Severe Spontaneous Intracerebral Hemorrhage: a Retrospective Cohort Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 678
- 试验地点
- 1
- 主要终点
- Functional status at 6 months
研究概览
简要总结
Spontaneous intracerebral hemorrhage (ICH) represents 10-15% of all strokes and is associated with high mortality and morbidity. Rapid identification and interventions, e.g. early implementation of care bundles, seem to be critical for improving outcome. Nonetheless, relatively little is known about the influence of acute physiological risk factors in the prehospital phase, although high prehospital blood pressure has been associated with worse outcome in mild to moderate ICH. Whether the same applies to severe ICH requiring neurointensive care is unclear and furthermore the prognostic impact of other physiological variables has received little attention. The aim of this study is to retrospectively investigate prehospital characteristics of severe ICH and whether physiological abnormalities are associated with functional outcome, mortality after six months, and early withdrawal of life sustaining treatment.
详细描述
This study investigates the association between prehospital blood pressure, neurological deficits, glucose, hypoxia and outcome in patients admitted to the neurointensive care unit at Copenhagen University Hospital, Rigshospitalet, between 11-01-2016 and 10-01-2025. All data pertaining to the first 24 hours from admission to first hospital, baseline characteristics, comorbidities, decisions to withdraw care within 24 hours and functional outcome and mortality at six months were extracted from electronic medical journals, while prehospital data was extracted from the Danish National Prehospital Database and supplemented with scanned EMS records when available.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Primary spontaneous ICH confirmed by CT imaging.
- •Admission to the neurointensive care unit at Rigshospitalet within the study period.
- •Available prehospital journal linked to the initial hospital admission.
排除标准
- •Age below 18
- •ICH secondary to trauma, vascular malformation, tumour, haemorrhagic transformation of ischaemic stroke, aneurysms, or central venous sinus thrombosis.
- •Initial admission without confirmed ICH.
- •Admissions from hospitals outside the Capital Region of Denmark or Region Zealand.
- •Pure intraventricular hemorrhage without parenchymal involvement as determined by a radiologist.
- •Intrahospital ICH.
- •Iatrogenic ICH
结局指标
主要结局
Functional status at 6 months
时间窗: Time Frame: From ictus onset of symptoms or last seen well to six months
Modified Rankin Scale, mRS, (0-6 where lower scores mean a better outcome), with favourable outcomes defined as mRS of 0-3 and unfavourable 4-6
Mortality at 6 months
时间窗: From ictus to six months
Percent
Early withdrawal of life sustaining treatment
时间窗: First 24 hours from admission to primary hospital
Percent
次要结局
- In hospital death(From hospital admission at day 1 until any death date coinciding with hospital discharge, assessed up to 36 months)
- Length of stay(From hospital admission at day 1 to hospital discharge or in-hospital death, assessed up to 36 months)
研究者
Kirsten Moller
Clinical Professor
Rigshospitalet, Denmark