The influence of enlarged perivascular spaces on the prognosis of patients with intracerebral hemorrhage

Abstract

Objective To investigate the impact of enlarged perivascular spaces (EPVS) on the prognosis of patients with intracerebral hemorrhage (ICH). Methods A total of 306 ICH patients were enrolled in this study. The bleeding volume was calculated by Tada formula based on CT. The number and grade of EPVS were evaluated by MRI. Participants were assessed at 90 d after onset for functional outcome by the modified Rankin Scale (mRS) and quality of life by EuroQol Five Dimensions Questionnaire (EQ-5D). The cerebrovascular events were recorded within one-year follow-up. Results Patients were divided into EPVS group (N = 129) and non-EPVS group (N = 177). The rate of poor functional outcome [75.97% (98/129) vs. 36.16% (64/177); χ² = 47.469, P = 0.000] and the rate of poor quality of life [44.19%(57/129) vs. 20.34% (36/177); χ² = 20.058, P = 0.000] in EPVS group were significantly higher than those in non-EPVS group. Subgroup analysis showed the rate of poor functional outcome [52% (39/75) vs. 77.78% (42/54); χ² = 8.929, P = 0.003] and the rate of poor quality of life [25.33% (19/75) vs. 55.56% (30/54); χ² = 12.173, P = 0.000] in mild EPVS group were significantly lower than those in severe EPVS group. During follow-up period, the recurrence rate of hemorrhagic stroke [6.98% (9/129) vs. 1.13% (2/177); adjusted χ² =5.770, P = 0.016] and ischemic stroke [12.40% (16/129) vs. 2.82% (5/177); χ² = 10.710, P = 0.001] in EPVS group were significantly higher than those in non-EPVS group. Conclusions ICH patients with EPVS have poor functional outcome, poor quality of life and high risk of recurrent cerebrovascular events within one year. EPVS can be the predictor for poor prognosis of ICH patients.

DOI: 10.3969/j.issn.1672-6731.2018.11.009