Stroke: Combination of abnormal physiological parameters and warfarin use is associated with poor outcomes in intracerebral hemorrhage

A new study, published in the American Heart Association’s Stroke journal, has revealed that a combination of abnormal physiological variables and warfarin use has strong associations with poor outcomes in intracerebral haemorrhage.

Researchers from The George Institute China conducted post hoc analyzes of INTERACT2 (Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial) that compared different levels of systolic blood pressure control (<140 versus <180 mm Hg) in 2839 hypertensive patients with intracerebral hemorrhage (onset <6 hours). Statistical modelling that adjusted for different variables were used to define associations of baseline scores assigned as 0 to 6 per 10 mm Hg systolic blood pressure increase (range, 150–220 mm Hg) and 0 or 1 for serum glucose (≤6.5 versus >6.5 mmol/L), body temperature (≤37.5 °C versus >37.5 °C), and warfarin use (no versus yes) and death or major disability (modified Rankin Scale scores 3–6 at 90 days).

The distribution of these scores among participants was 0 (7.7%), 1 (15.6%), 2 (19.0%), 3 (19.1%), 4 (15.2%), 5 (11.6%), 6 (8.9%), and 7 (2.9%). After adjustment for baseline neurological severity and several other variables, significant linear associations were evident for increasing (per point) score and death or major disability, death , and major disability.

Dr. Lili Song, first author of the paper and senior research fellow at The George Institute China said, “The study confirmed a strong correlation between a cluster of four physiological parameters of blood pressure, blood glucose, body temperature, and history of antithrombotic drugs, on adverse outcomes in strokes due to hemorrhage. These data provide a strong basis for our ongoing INTERACT3 project, which we hope will form a widely applied management protocol to optimize recovery from this serious illness”