Outcomes after intracerebral hemorrhage from arteriovenous malformations.

TitleOutcomes after intracerebral hemorrhage from arteriovenous malformations.
Publication TypeJournal Article
Year of Publication2017
AuthorsMurthy SB, Merkler AE, Omran SSalehi, Gialdini G, Gusdon A, Hartley B, Roh D, Mangat HS, Iadecola C, Navi BB, Kamel H
Date Published2017 May 16
KeywordsAdult, Aged, Aged, 80 and over, Cerebral Hemorrhage, Comorbidity, Female, Hospital Mortality, Humans, Intracranial Arteriovenous Malformations, Logistic Models, Male, Middle Aged, Odds Ratio, Patient Discharge, Prospective Studies, Retrospective Studies, Treatment Outcome, United States

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.

Alternate JournalNeurology
PubMed ID28424275
PubMed Central IDPMC5444313