Older age is a strong predictor for poor outcome in intracerebral haemorrhage: The INTERACT2 study

The INTERACT2 investigators, Karin Rådholm, Hisatomi Arima, Richard I. Lindley, Jiguang Wang, Christophe Tzourio, Thompson Robinson, Emma Heeley, Craig S. Anderson, John Chalmers

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)

Abstract

Background and purpose: Global ageing contributes greatly to the burden of stroke. We investigated the influence of age on the baseline profile and on outcomes in acute intracerebral haemorrhage (ICH) among participants of the INTERACT2 study. Methods: INTERACT2 was an international, randomised controlled trial in 2839 patients with spontaneous ICH within 6 h of onset and elevated systolic blood pressure (SBP; 150-220 mmHg) who were allocated to receive intensive (target SBP <140 mmHg within 1 h) or guideline-recommended (target SBP <180 mmHg) blood pressure lowering treatment. Stroke severity was assessed with the National Institutes of Health Stroke Scale. Poor outcome was defined as death or major disability ('dependency', modified Rankin Scale scores 3-6) at 90 days. Health-related quality of life (HRQoL) was assessed with the European Quality of Life-5 Dimensions (EQ-5D) questionnaire. Associations between age and outcomes were analysed in multivariable logistic regression models. Results: Stroke severity increased in categories of older age (P-trend 0.002). Stroke patients over 75 years old were four times more likely to die or be disabled at 90 days than those <52 years when other confounders were accounted for (odds ratio 4.36, 95% confidence interval 3.12-6.08). Older age was also associated with decreasing HRQoL, across mobility, self-care, usual activities and depression (all P-trend <0.001), and pain or discomfort (P-trend 0.022). Conclusion: In the INTERACT2 cohort, older people had more severe ICH and worse outcomes (death, major disability and HRQoL). These data will help guide clinicians manage older people with haemorrhagic stroke.

Original languageEnglish
Pages (from-to)422-427
Number of pages6
JournalAge and Ageing
Volume44
Issue number3
DOIs
Publication statusPublished - May 2015
Externally publishedYes

Keywords

  • Ageing
  • Death
  • Dependency
  • Intracerebral haemorrhage
  • Quality of life

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