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Prognostic value of perihematomal edema area at the initial ED presentation in patients with intracranial hematoma - 27/06/16

Doi : 10.1016/j.ajem.2016.03.048 
Serife Ozdinc, MD a, , Ebru Unlu, MD b , Zeynep Karakaya, MD c , Ozan Turamanlar, MD d , Nurhan Dogan, PhD e , Yesim Isler, MD f , Yucel Gonul, PhD d , Mehmet Gazi Boyaci, MD g
a Afyon Kocatepe University, School of Medicine, Department of Emergency Medicine, Afyonkarahisar, Turkey 
b Afyon Kocatepe University, School of Medicine, Department of Radiology, Afyonkarahisar, Turkey 
c İzmir Katip Celebi University, Atatürk Training and Research Hospital, Clinic of Emergency Medicine, Izmir, Turkey 
d Afyon Kocatepe University, School of Medicine, Department of Anatomy, Afyonkarahisar, Turkey 
e Afyon Kocatepe University, School of Medicine, Department of Biostatistics and Medical Informatics, Afyonkarahisar, Turkey 
f Bursa Yuksek Ihtisas Training and Research Hospital, Clinic of Emergency Medicine, Bursa, Turkey 
g Afyon Kocatepe University, School of Medicine, Department of Neurosurgery, Afyonkarahisar, Turkey 

Corresponding author at: Afyon Kocatepe Universitesi, Tip fakultesi, Acil Tip AD. Ali Cetinkaya Kampusu, Afyonkarahisar, Turkiye. Tel.: +90 272 2463303; fax: +90 272 2463300.Afyon Kocatepe Universitesi, Tip fakultesi, Acil Tip AD. Ali Cetinkaya Kampusu, Afyonkarahisar, Turkiye

Abstract

Objective

Intracerebral hemorrhage (ICH) is a potentially life-threatening condition. Interventions and treatments should be managed on time to reduce mortality. It has been put forth that perihematomal edema absolute volume (PHEAV) is related to mortality, however the effect of perihematomal edema absolute area (PHEAA) on mortality is unknown. The objective of this study was to evaluate the effect of PHEAA on 30-day mortality in patients with ICH.

Methods

Patients were screened with ICD-9, retrospectively. 106 patients were included in the study. Clinical data were obtained from the patient files. Computed tomography (CT) was acquired from the hospital imaging database. PHEAV and PHEAA were measured via CT by two clinicians blinded to the study protocol. The predictors of 30- day mortality were examined.

Results

Forty-three (40.6%) patients died within 30days. Older age, lack of trauma, low Glasgow coma scale and high blood glucose were associated with high mortality (P.001). PHEAV and PHEAA values were higher in nonsurvivors (P<.001). PHEAA was detected as an independent predictor of 30-day mortality. The cutoff value of PHEAA for mortality was 33.41cm2 (sensitivity: 84.4%, specificity: 59.0%). There was no difference between receiver operating characteristic curves of PHEAA and PHEAV (P=.55).

Conclusion

In contrast to PHEAV, PHEAA is a simple value which can be measured without the requirement of any additional techniques or extra costs which can be quickly applied and which is an independent indicator of 30-day mortality. PHEAA can accelerate physician interventions for patients with ICH within several hours of ED admission.

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☆☆ This manuscript hasn't been presented at any organization.


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Vol 34 - N° 7

P. 1241-1246 - juillet 2016 Retour au numéro
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