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Author: search.filters.author.Xia WangSubject: search.filters.subject.outcome

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    Scopus© Citations 12  1
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    Quantifying regional variations in components of acute stroke unit (ASU) care in the international HeadPoST study
    (2020)
    Menglu Ouyang
    ;
    Yao Zhang
    ;
    Xia Wang
    ;
    Lili Song
    ;
    Laurent Billot
      1Scopus© Citations 6
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    Prognostic Significance of Hyperglycemia in Acute Intracerebral Hemorrhage The INTERACT2 Study
    (2016)
    Anubhav Saxena
    ;
    Craig S. Anderson
    ;
    Xia Wang
    ;
    Shoichiro Sato
    ;
    Hisatomi Arima
    <jats:sec> <jats:title>Background and Purpose—</jats:title> <jats:p>We aimed to determine associations of baseline blood glucose and diabetes mellitus with clinical outcomes in participants of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2).</jats:p> </jats:sec> <jats:sec> <jats:title>Methods—</jats:title> <jats:p>INTERACT2 was an international prospective, open, blinded end point, randomized controlled trial of 2839 patients with spontaneous intracerebral hemorrhage (&lt;6 hours) and elevated systolic blood pressure randomly assigned to intensive (target systolic blood pressure &lt;140 mm Hg) or guideline-based (systolic blood pressure &lt;180 mm Hg) BP management. Associations of hyperglycemia at presentation (&gt;6.5 mmol/L) and combined and separate poor outcomes of death and major disability (scores of 3–6, 3–5, and 6, respectively, on the modified Rankin scale) at 90 days were determined in logistic regression models.</jats:p> </jats:sec> <jats:sec> <jats:title>Results—</jats:title> <jats:p> In 2653 patients with available data, there were 1348 (61%) with hyperglycemia and 292 (11%) with diabetes mellitus. Associations of baseline blood glucose and poor outcome were strong and near continuous. After adjustment for baseline variables, the highest fourth (7.9–25.0 mmol/L) of blood glucose was significantly associated with combined poor outcome (adjusted odds ratio 1.35, 95% confidence interval 1.01–1.80; <jats:italic>P</jats:italic> trend 0.015). Diabetes mellitus also predicted poor outcome (adjusted odds ratio 1.46, 95% confidence interval 1.05–2.02; <jats:italic>P</jats:italic> =0.023), though more important for residual disability than death on separate analysis. </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions—</jats:title> <jats:p>Hyperglycemia and diabetes mellitus are independent predictors of poor outcome in patients with predominantly mild to moderate severity of intracerebral hemorrhage. These data support guideline recommendations for good glycemic control in patients with intracerebral hemorrhage.</jats:p> </jats:sec> <jats:sec> <jats:title>Clinical Trial Registration—</jats:title> <jats:p> URL: <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov">http://www.clinicaltrials.gov</jats:ext-link> . Unique identifier: NCT00716079. </jats:p> </jats:sec>
      5Scopus© Citations 118
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      8Scopus© Citations 41
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    Prophylactic heparin in acute intracerebral hemorrhage: a propensity score-matched analysis of the INTERACT2 study
    (2016)
    MUÑOZ VENTURELLI, PAULA ANDREA  
    ;
    Xia Wang
    ;
    Pablo M Lavados
    ;
    Christian Stapf
    ;
    Thompson Robinson
    <jats:sec><jats:title>Background</jats:title><jats:p> Indication and timing of pharmacological venous thromboembolism prophylaxis in intracerebral hemorrhage patients is controversial. </jats:p></jats:sec><jats:sec><jats:title>Aims</jats:title><jats:p> To determine whether use of subcutaneous heparin during the first 7 days after spontaneous intracerebral hemorrhage increases risks of death and disability. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> Data are from the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2) study. Patients with acute intracerebral hemorrhage (&lt;6 hours) and elevated systolic blood pressure were included; patients received subcutaneous heparin following local best practice standards of care. Multivariable logistic regression and propensity score matched analysis were used to determine associations of heparin use on death and disability (modified Rankin scale) at 90 days. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> In 2525 patients with available data, there were 465 (22.5%) who received subcutaneous heparin. They had higher death or major disability at 90 days in crude (odds ratio 2.29, 95% confidence interval 1.85–2.84; p &lt; 0.001), adjusted (odds ratio 1.62, 95% confidence interval 1.26–2.09; p &lt; 0.001) and propensity score matched (odds ratio 2.06, 95% confidence interval 1.53–2.77; p &lt; 0.001) analyses. In propensity score matched analysis, heparin-treated patients had significant lower mortality (odds ratio 0.55, 95% CI 0.35–0.87; p = 0.01) but greater major disability (odds ratio 1.68, 95% confidence interval 1.25–2.28; p &lt; 0.001) at 90 days. However, no mortality difference was found in analysis restricted to 48-hour survivors. </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Use of subcutaneous heparin is associated with poor outcome in acute intracerebral hemorrhage, driven by increased residual disability. Despite the limitations of this study, and no clear relation of heparin with bleeding risk, we recommend careful consideration of the need for venous thromboembolism prophylaxis with heparin in intracerebral hemorrhage patients. </jats:p></jats:sec><jats:sec><jats:title>Trial registration</jats:title><jats:p> http://www.clinicaltrials.gov NCT00716079. </jats:p></jats:sec>
    Scopus© Citations 14  1
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    Scopus© Citations 6  7