TY - JOUR AU - Arima H. AU - Sato S. AU - Anderson Craig AU - Zheng D. AU - Carcel C. AU - Chalmers J. AU - Cao Y. AB -

Previous studies consistently reported a diurnal variation in the occurrence of intracerebral hemorrhage (ICH), with a morning peak. However, limited knowledge exists on the circadian pattern of ICH severity and outcome. This study aimed to determine possible associations between ICH onset time and admission severity and 90-day outcomes using the combined data set of the pilot and main-phase Intensive blood pressure (BP) reduction in an acute cerebral hemorrhage trial (INTERACT). The ICH onset time was categorized into three groups (1: 00:00-07:59; 2: 08:00-15:59; and 3: 16:00-23:59). We found an association between onset time and low Glasgow Coma Scale score: aOR (time 1: 1.72, 95% CI 1.12-2.66; time 3: 1.95, 95% CI 1.31-2.89, p = 0.003; in comparison to time 2). There was no association between onset time and volume of ICH (adjusted p = 0.354) or 90-day outcomes of death or major disability, and death and major disability separately (all adjusted p > 0.4). The results showed that more severe cases of ICH patients, defined by a reduced level of consciousness, had late afternoon to early morning stroke onset, but this was unrelated to baseline hematoma volume or location. There was no circadian influence on ICH clinical outcome.

AD - a Neurological and Mental Health Division , The George Institute for Global Health , Sydney , Australia.
b Sydney Medical School , The University of Sydney , Sydney , Australia.
c Department of Cerebrovascular Medicine , National Cerebral and Cardiovascular Center , Osaka , Japan.
d Department of Neurology , The Second Affiliated Hospital of Soochow University , Suzhou , China.
e Department of Preventive Medicine and Public Health , Faculty of Medicine, Fukuoka University , Fukuoka , Japan.
f Department of Neurology , Royal Prince Alfred Hospital , Sydney , Australia. AN - 27485147 BT - Chronobiology International CN - [IF]: 3.540 DP - NLM ET - 2016/08/04 LA - Eng LB - AUS
NMH
PROF
FY17 N1 - Zheng, Danni
Sato, Shoichiro
Cao, Yong-Jun
Arima, Hisatomi
Carcel, Cheryl
Chalmers, John
Anderson, Craig S
INTERACT investigators
Chronobiol Int. 2016 Aug 2:1-6. N2 -

Previous studies consistently reported a diurnal variation in the occurrence of intracerebral hemorrhage (ICH), with a morning peak. However, limited knowledge exists on the circadian pattern of ICH severity and outcome. This study aimed to determine possible associations between ICH onset time and admission severity and 90-day outcomes using the combined data set of the pilot and main-phase Intensive blood pressure (BP) reduction in an acute cerebral hemorrhage trial (INTERACT). The ICH onset time was categorized into three groups (1: 00:00-07:59; 2: 08:00-15:59; and 3: 16:00-23:59). We found an association between onset time and low Glasgow Coma Scale score: aOR (time 1: 1.72, 95% CI 1.12-2.66; time 3: 1.95, 95% CI 1.31-2.89, p = 0.003; in comparison to time 2). There was no association between onset time and volume of ICH (adjusted p = 0.354) or 90-day outcomes of death or major disability, and death and major disability separately (all adjusted p > 0.4). The results showed that more severe cases of ICH patients, defined by a reduced level of consciousness, had late afternoon to early morning stroke onset, but this was unrelated to baseline hematoma volume or location. There was no circadian influence on ICH clinical outcome.

PY - 2016 SN - 1525-6073 (Electronic)
0742-0528 (Linking) SP - 1 EP - 6 T2 - Chronobiology International TI - Circadian variation in clinical features and outcome of intracerebral hemorrhage: The INTERACT studies Y2 - FY17 ER -