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Early Cognitive Impairment after Intracerebral Hemorrhage in the INTERACT1 Study.

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journal contribution
posted on 2018-01-16, 15:58 authored by S. You, X. Wang, R. I. Lindley, T. Robinson, C. S. Anderson, Y. Cao, J. Chalmers
BACKGROUND: Data on cognitive impairment after acute intracerebral hemorrhage (ICH) are limited. This study is aimed at determining the frequency and predictors of cognitive impairment among participants of the pilot phase, Intensive Blood Pressure (BP) Reduction in Acute Cerebral Hemorrhage Trial (INTERACT1). METHODS: INTERACT1 was an open randomized trial of early intensive (target systolic BP <140 mm Hg) compared with contemporaneous guideline-recommended BP lowering in 404 patients with elevated systolic BP (150-220 mm Hg) within 6 h of ICH onset. Cognitive impairment was defined by scores ≤24 on the Mini-Mental State Examination (MMSE) assessed by interview on follow-up at 90 days. RESULTS: A total of 231 (64.5%) of 358 90-day survivors had MMSE scores for analyses, and 75 (32.5%) had cognitive impairment. In multivariable analysis, older age (OR 2.48, 95% CI 1.73-3.56 per 10-year increase; p < 0.001), female sex (OR 2.06, 95% CI 1.00-4.23; p = 0.049), prior ICH (OR 2.87, 95% CI 1.08-7.65; p = 0.035), high baseline National Institute of Health Stroke Scale score (OR 1.06, 95% CI 1.00-1.13; p = 0.044), and high mean systolic BP over the first 24 h post-randomization (OR 1.34, 95% CI 1.07-1.68/10 mm Hg increase; p = 0.011) were independently associated with cognitive impairment. CONCLUSIONS: One third of patients have significant cognitive impairment early after ICH, which is more frequent in the elderly, females, those with prior ICH, and more severe initial neurological deficit and with persistently high early systolic BP.

Funding

The INTERACT1 study was supported by a program (ID 358395) grant from the National Health and Medical Research Council of Australia.

History

Citation

Cerebrovascular Diseases, 2017, 44 (5-6), pp. 320-324

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Cardiovascular Sciences

Version

  • AM (Accepted Manuscript)

Published in

Cerebrovascular Diseases

Publisher

Karger Publishers

issn

1015-9770

eissn

1421-9786

Acceptance date

2017-09-11

Copyright date

2017

Available date

2018-01-16

Publisher version

https://www.karger.com/Article/Abstract/481443

Language

en

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