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...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-06-01
|
| Series: | Annals of Clinical and Translational Neurology |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/acn3.70048 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850220200849309696 |
|---|---|
| author | Anne Mrochen Maximilian I. Sprügel Alexander Sekita Stefanie Balk David Haupenthal Stefan T. Gerner Hannes Lücking Arnd Doerfler Kosmas Macha Stefan Schwab Joji B. Kuramatsu Jochen A. Sembill |
| author_facet | Anne Mrochen Maximilian I. Sprügel Alexander Sekita Stefanie Balk David Haupenthal Stefan T. Gerner Hannes Lücking Arnd Doerfler Kosmas Macha Stefan Schwab Joji B. Kuramatsu Jochen A. Sembill |
| author_sort | Anne Mrochen |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-e57112490e4b40c4aec2f1f09a0cad1c |
| institution | OA Journals |
| issn | 2328-9503 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Clinical and Translational Neurology |
| spelling | doaj-art-e57112490e4b40c4aec2f1f09a0cad1c2025-08-20T02:07:09ZengWileyAnnals of Clinical and Translational Neurology2328-95032025-06-011261144115010.1002/acn3.70048Long‐Term Survival, Burden of Disease, and Patient‐Centered Outcomes in Maximally Treated Intracerebral HemorrhageAnne Mrochen0Maximilian I. Sprügel1Alexander Sekita2Stefanie Balk3David Haupenthal4Stefan T. Gerner5Hannes Lücking6Arnd Doerfler7Kosmas Macha8Stefan Schwab9Joji B. Kuramatsu10Jochen A. Sembill11Department of Neurology University Hospital Erlangen Erlangen GermanyDepartment of Neurology University Hospital Erlangen Erlangen GermanyDepartment of Neurology University Hospital Erlangen Erlangen GermanyDepartment of Neurology University Hospital Erlangen Erlangen GermanyDepartment of Neurology University Hospital Erlangen Erlangen GermanyDepartment of Neurology University Hospital Erlangen Erlangen GermanyDepartment of Neuroradiology University Hospital Erlangen Erlangen GermanyDepartment of Neuroradiology University Hospital Erlangen Erlangen GermanyDepartment of Neurology University Hospital Erlangen Erlangen GermanyDepartment of Neurology University Hospital Erlangen Erlangen GermanyDepartment of Neurology University Hospital Erlangen Erlangen GermanyDepartment of Neurology University Hospital Erlangen Erlangen GermanyABSTRACT 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.https://doi.org/10.1002/acn3.70048intracerebral hemorrhage prognosispatient‐centered outcomesstroke disability burden |
| spellingShingle | Anne Mrochen Maximilian I. Sprügel Alexander Sekita Stefanie Balk David Haupenthal Stefan T. Gerner Hannes Lücking Arnd Doerfler Kosmas Macha Stefan Schwab Joji B. Kuramatsu Jochen A. Sembill Long‐Term Survival, Burden of Disease, and Patient‐Centered Outcomes in Maximally Treated Intracerebral Hemorrhage Annals of Clinical and Translational Neurology intracerebral hemorrhage prognosis patient‐centered outcomes stroke disability burden |
| title | Long‐Term Survival, Burden of Disease, and Patient‐Centered Outcomes in Maximally Treated Intracerebral Hemorrhage |
| title_full | Long‐Term Survival, Burden of Disease, and Patient‐Centered Outcomes in Maximally Treated Intracerebral Hemorrhage |
| title_fullStr | Long‐Term Survival, Burden of Disease, and Patient‐Centered Outcomes in Maximally Treated Intracerebral Hemorrhage |
| title_full_unstemmed | Long‐Term Survival, Burden of Disease, and Patient‐Centered Outcomes in Maximally Treated Intracerebral Hemorrhage |
| title_short | Long‐Term Survival, Burden of Disease, and Patient‐Centered Outcomes in Maximally Treated Intracerebral Hemorrhage |
| title_sort | long term survival burden of disease and patient centered outcomes in maximally treated intracerebral hemorrhage |
| topic | intracerebral hemorrhage prognosis patient‐centered outcomes stroke disability burden |
| url | https://doi.org/10.1002/acn3.70048 |
| work_keys_str_mv | AT annemrochen longtermsurvivalburdenofdiseaseandpatientcenteredoutcomesinmaximallytreatedintracerebralhemorrhage AT maximilianisprugel longtermsurvivalburdenofdiseaseandpatientcenteredoutcomesinmaximallytreatedintracerebralhemorrhage AT alexandersekita longtermsurvivalburdenofdiseaseandpatientcenteredoutcomesinmaximallytreatedintracerebralhemorrhage AT stefaniebalk longtermsurvivalburdenofdiseaseandpatientcenteredoutcomesinmaximallytreatedintracerebralhemorrhage AT davidhaupenthal longtermsurvivalburdenofdiseaseandpatientcenteredoutcomesinmaximallytreatedintracerebralhemorrhage AT stefantgerner longtermsurvivalburdenofdiseaseandpatientcenteredoutcomesinmaximallytreatedintracerebralhemorrhage AT hanneslucking longtermsurvivalburdenofdiseaseandpatientcenteredoutcomesinmaximallytreatedintracerebralhemorrhage AT arnddoerfler longtermsurvivalburdenofdiseaseandpatientcenteredoutcomesinmaximallytreatedintracerebralhemorrhage AT kosmasmacha longtermsurvivalburdenofdiseaseandpatientcenteredoutcomesinmaximallytreatedintracerebralhemorrhage AT stefanschwab longtermsurvivalburdenofdiseaseandpatientcenteredoutcomesinmaximallytreatedintracerebralhemorrhage AT jojibkuramatsu longtermsurvivalburdenofdiseaseandpatientcenteredoutcomesinmaximallytreatedintracerebralhemorrhage AT jochenasembill longtermsurvivalburdenofdiseaseandpatientcenteredoutcomesinmaximallytreatedintracerebralhemorrhage |