Intracerebral Haemorrhage in the Top End of the Northern Territory; Risk Factors, Outcomes and the Presence of Cerebral Amyloid Angiopathy in Indigenous Peoples.
Marianna Diamandopoulos, Alvaro Cervera, Geoffrey A Donnan
PMID 42415495WHAT IT FOUND
Functional recovery was poor after intracerebral haemorrhage: only 30.1% were independent at discharge, and with chronic kidney disease only 11.4% were independent.
This was an observational hospital audit, not a treatment trial.
Key findings
01Of 156 patients with intracerebral haemorrhage, mortality at discharge was 37.2%, and only 30.1% were independent at discharge.
02Among patients with chronic kidney disease, mortality at discharge was 59.1%, and only 11.4% were independent at discharge.
03The regression analysis identified chronic kidney disease and haemorrhage volume as independent predictors of mortality, with reported odds ratios of 5.47 and 1.05.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
This was a retrospective record review, not a treatment trial, so it can show associations but cannot prove that chronic kidney disease caused death or dependence. It was a single hospital audit with 156 patients, and only 21 had probable cerebral amyloid angiopathy and 18 had possible cerebral amyloid angiopathy. MRI was done in only 39.1% of patients and in only 3.4% of those who died, compared with 60.2% of survivors, so cerebral amyloid angiopathy and its relation to outcome were likely underestimated. Records were incomplete because data were extracted from existing charts. The study did not test rehabilitation or treatment, so it cannot tell clinicians whether a different care plan would improve outcomes.
Declared interests
The paper states the authors have nothing to report.
The easy way to misread this
Do not treat the cerebral amyloid angiopathy findings as reliable. MRI was done in only 39.1% of patients and in only 3.4% of patients who died, so cerebral amyloid angiopathy was likely underestimated. Do not conclude that chronic kidney disease caused death, because this was an observational record review.