RT Journal Article
SR Electronic
T1 Outcomes after intracerebral hemorrhage from arteriovenous malformations
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 1882
OP 1888
DO 10.1212/WNL.0000000000003935
VO 88
IS 20
A1 Murthy, Santosh B.
A1 Merkler, Alexander E.
A1 Omran, Setareh Salehi
A1 Gialdini, Gino
A1 Gusdon, Aaron
A1 Hartley, Benjamin
A1 Roh, David
A1 Mangat, Halinder S.
A1 Iadecola, Costantino
A1 Navi, Babak B.
A1 Kamel, Hooman
YR 2017
UL http://n.neurology.org/content/88/20/1882.abstract
AB Objective: To compare outcomes after intracerebral hemorrhage (ICH) from cerebral arteriovenous malformation (AVM) rupture and other causes of ICH.Methods: We performed a retrospective population-based study using data from the Nationwide Inpatient Sample. We used standard diagnosis codes to identify ICH cases from 2002 to 2011. Our predictor variable was cerebral AVM. Our primary outcomes were inpatient mortality and home discharge. We used logistic regression to compare outcomes between patients with ICH with and without AVM while adjusting for demographics, comorbidities, and hospital characteristics. In a confirmatory analysis using a prospective cohort of patients hospitalized with ICH at our institution, we additionally adjusted for hematoma characteristics and the Glasgow Coma Scale score.Results: Among 619,167 ICH hospitalizations, the 4,485 patients (0.7%, 95% confidence interval [CI] 0.6–0.8) with an AVM were younger and had fewer medical comorbidities than patients without AVM. After adjustment for confounders, patients with AVM had lower odds of death (odds ratio [OR] 0.5, 95% CI 0.4–0.7) and higher odds of home discharge (OR 2.0, 95% CI 1.4–3.0) than patients without AVM. In a confirmatory analysis of 342 patients with ICH at our institution, the 34 patients (9.9%, 95% CI 7.2–13.6) with a ruptured AVM had higher odds of ambulatory independence at discharge (OR 4.4, 95% CI 1.4–13.1) compared to patients without AVM.Conclusions: Patients with ICH due to ruptured AVM have more favorable outcomes than patients with ICH from other causes.ARUBA=A Randomized Trial of Unruptured Brain Arteriovenous Malformations; AVM=arteriovenous malformation; CAESAR=Cornell Acute Stroke Academic Registry; CI=confidence interval; ICD-9-CM=International Classification of Diseases, Ninth Revision, Clinical Modification; ICH=intracerebral hemorrhage; NIS=Nationwide Inpatient Sample; OR=odds ratio