TY - JOUR
T1 - Circadian variation in clinical features and outcome of intracerebral hemorrhage
T2 - The INTERACT studies
AU - Zheng, Danni
AU - Sato, Shoichiro
AU - Cao, Yong Jun
AU - Arima, Hisatomi
AU - Carcel, Cheryl
AU - Chalmers, John
AU - Anderson, Craig S.
AU - INTERACT Investigators
PY - 2016/8/2
Y1 - 2016/8/2
N2 - Previous studies consistently reported a diurnal variation in the occurrence of intracerebral hemorrhage (ICH), with a morning peak. However, limited knowledge exists on the circadian pattern of ICH severity and outcome. This study aimed to determine possible associations between ICH onset time and admission severity and 90-day outcomes using the combined data set of the pilot and main-phase Intensive blood pressure (BP) reduction in an acute cerebral hemorrhage trial (INTERACT). The ICH onset time was categorized into three groups (1: 00:00–07:59; 2: 08:00–15:59; and 3: 16:00–23:59). We found an association between onset time and low Glasgow Coma Scale score: aOR (time 1: 1.72, 95% CI 1.12–2.66; time 3: 1.95, 95% CI 1.31–2.89, p = 0.003; in comparison to time 2). There was no association between onset time and volume of ICH (adjusted p = 0.354) or 90-day outcomes of death or major disability, and death and major disability separately (all adjusted p > 0.4). The results showed that more severe cases of ICH patients, defined by a reduced level of consciousness, had late afternoon to early morning stroke onset, but this was unrelated to baseline hematoma volume or location. There was no circadian influence on ICH clinical outcome.
AB - Previous studies consistently reported a diurnal variation in the occurrence of intracerebral hemorrhage (ICH), with a morning peak. However, limited knowledge exists on the circadian pattern of ICH severity and outcome. This study aimed to determine possible associations between ICH onset time and admission severity and 90-day outcomes using the combined data set of the pilot and main-phase Intensive blood pressure (BP) reduction in an acute cerebral hemorrhage trial (INTERACT). The ICH onset time was categorized into three groups (1: 00:00–07:59; 2: 08:00–15:59; and 3: 16:00–23:59). We found an association between onset time and low Glasgow Coma Scale score: aOR (time 1: 1.72, 95% CI 1.12–2.66; time 3: 1.95, 95% CI 1.31–2.89, p = 0.003; in comparison to time 2). There was no association between onset time and volume of ICH (adjusted p = 0.354) or 90-day outcomes of death or major disability, and death and major disability separately (all adjusted p > 0.4). The results showed that more severe cases of ICH patients, defined by a reduced level of consciousness, had late afternoon to early morning stroke onset, but this was unrelated to baseline hematoma volume or location. There was no circadian influence on ICH clinical outcome.
KW - cerebral hemorrhage
KW - circadian rhythm
KW - diurnal variation
KW - Hemorrhagic stroke
UR - http://www.scopus.com/inward/record.url?scp=84980374186&partnerID=8YFLogxK
U2 - 10.1080/07420528.2016.1210158
DO - 10.1080/07420528.2016.1210158
M3 - Article
C2 - 27485147
AN - SCOPUS:84980374186
SN - 0742-0528
VL - 33
SP - 1182
EP - 1187
JO - Chronobiology International
JF - Chronobiology International
IS - 9
ER -