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INTERACT2 Treatment withdrawal following ICH FINAL ANONYMISED Age Ageing july2016 CLEAN.pdf (251.81 kB)

Withdrawal of active treatment after intracerebral haemorrhage in the INTERACT2 study

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posted on 2017-11-23, 10:33 authored by Paula Muñoz Venturelli, Xia Wang, Darin B. Zahuranec, Pablo M. Lavados, Christian Stapf, Richard Lindley, Candice Delcourt, John Chalmers, Craig S. Anderson, Thompson G. Robinson, INTERACT2 Investigators
Background: in the second Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT2), a minority of patients received withdrawal of active treatment (WAT). We wished to determine the characteristics of these patients, and the relation of this decision-making to subsequent management and final outcome. Methods: the INTERACT2 cohort of acute intracerebral haemorrhage (ICH) patients had a decision of WAT within 7 days after hospital admission recorded. Multivariable logistic regression was used to identify the determinants of WAT and poor outcome at 90 days, defined by modified Rankin scale (mRS) scores 3-6. Results: of 2,779 participants with available data, WAT occurred in 121 (4%) and this was significantly associated with increasing age, greater neurological severity, larger haematoma volume, intraventricular extension and randomisation to intensive BP lowering. Compared to other patients, those with WAT had greater mortality (81/121 [67%] versus 205/2624 [8%]; P < 0.001) and survivors were more likely to be severely disabled (mRS score 4-5, 19/39 [49%] versus 695/2419 [29%]; P = 0.006). Conclusions: WAT was undertaken in patients with recognised predictors of poor prognosis, who subsequently were more likely to die or be left with severe disability. Improved understanding of specific factors determining WAT in ICH patients might improve care delivery and outcomes. Clinical Trial Registration: the INTERACT2 study is registered with ClinicalTrials.gov (NCT00716079).

History

Citation

Age and Ageing, 2017, 46 (2), pp. 329-332

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Cardiovascular Sciences

Version

  • AM (Accepted Manuscript)

Published in

Age and Ageing

Publisher

Oxford University Press for British Geriatrics Society

issn

0002-0729

eissn

1468-2834

Acceptance date

2016-08-24

Copyright date

2016

Available date

2017-11-23

Publisher version

https://academic.oup.com/ageing/article/46/2/329/2452294

Language

en

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