Long‐Term Survival, Burden of Disease, and Patient‐Centered Outcomes in Maximally Treated Intracerebral Hemorrhage
ABSTRACT Objective Increasing evidence shows that patients with intracerebral hemorrhage (ICH) can achieve better‐than‐expected outcomes with aggressive therapy. However, real‐world long‐term data, patient‐centered outcomes, and societal measures after maximal ICH treatment are lacking. This study a...
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| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-06-01
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| Series: | Annals of Clinical and Translational Neurology |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/acn3.70048 |
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| Summary: | ABSTRACT Objective Increasing evidence shows that patients with intracerebral hemorrhage (ICH) can achieve better‐than‐expected outcomes with aggressive therapy. However, real‐world long‐term data, patient‐centered outcomes, and societal measures after maximal ICH treatment are lacking. This study aimed to analyze 5‐year survival, utility‐weighted functional outcomes, and burden of disease in maximally treated ICH patients, stratified by max‐ICH Score. Methods This study investigated consecutive patients with spontaneous ICH included in the single‐center Longitudinal Cohort Study on ICH Care (UKER‐ICH, NCT03183167, 2006–2015). We included all patients without early care limitations, hereinafter referred to as maximally treated. We analyzed the stratification by max‐ICH Score of cumulative 5‐year survival using Kaplan–Meier estimates and COX regression modeling, disease burden using disability‐adjusted life years (DALYs), and patient‐centered outcome at 12 months using the Utility‐Weighted modified Rankin Scale (UW‐mRS). Results The 5‐year survival rate of the included 1022 maximally treated patients was 53%, stratified by max‐ICH Score (0 points: 85%, 1: 91%, 2: 69%, 3: 59%, 4: 47%, 5: 32%, 6: 29%, 7: 18%, ≥ 8: 0%, log‐rank p < 0.001). The mean number of DALYs was 8.94 (±8.15, standard deviation [SD]), consisting of 4.27 years of life lost (±7.79, SD) and 4.67 years lived with disability (±6.38, SD). Patients with a max‐ICH Score of 5 had the highest burden of disease (12.76 [±9.43, SD]). The mean UW‐mRS at 12 months was 0.45 (±0.37, SD) and decreased with increasing max‐ICH Score (0: 0.80 [±0.23], 1: 0.73 [±0.29], 2: 0.67 [±0.29], 3: 0.50 [±0.34], 4: 0.39 [±0.34], 5: 0.25 [±0.30], 6: 0.19 [±0.28], 7: 0.16 [±0.26], ≥ 8: 0.08 [±0.22], p < 0.001). Interpretation These observational data, stratified by max‐ICH Score, provide patients and treating physicians with an initial severity assessment in terms of potential long‐term patient‐centered outcomes and burden of disease following maximal treatment. |
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| ISSN: | 2328-9503 |