In order for the device to gain acceptance by medical professionals, smart glasses will need to be tailored to fit the needs of medical and surgical sub-specialties. Future studies will need to qualitatively assess the benefits of smart glasses as an adjunct to the current health information technology infrastructure.
Objective: To evaluate whether delayed appearance of intraventricular hemorrhage (dIVH) represents an independent entity from intraventricular hemorrhage (IVH) present on admission CT or is primarily related to the time interval between symptom onset and admission CT.Methods: A total of 282 spontaneous intracerebral hemorrhage (ICH) patients, admitted February 2009-March 2014 to the neurological intensive care unit of a tertiary care university hospital, were prospectively enrolled in the ICH Outcomes Project. Multivariate logistic regression was used to determine associations with acute mortality and functional long-term outcome (modified Rankin Scale).Results: A cohort of 282 ICH patients was retrospectively studied: 151 (53.5%) had intraventricular hemorrhage on initial CT scan (iIVH). Of the remaining 131 patients, 19 (14.5%) developed IVH after the initial CT scan (dIVH). The median times from symptom onset to admission CT were 1.1, 6.0, and 7.4 hours for the dIVH, iIVH, and no IVH groups (Mann-Whitney U test, dIVH vs iIVH, p , 0.001) and median time from onset to dIVH detection was 7.2 hours. The increase in ICH volume following hospital admission was larger in dIVH than in iIVH and no IVH patients (mean 17.6, 0.2, and 0.4 mL). After controlling for components of the ICH score and hematoma expansion, presence of IVH on initial CT was associated with discharge mortality and poor outcome at 3, 6, and 12 months, but dIVH was not associated with any of the outcome measures. Conclusions:In ICH patients, associated IVH on admission imaging is commonly encountered and is associated with poor long-term outcome. In contrast, dIVH on subsequent scans is far less common and does not appear to portend worse outcome. Neurology ® 2015;84:989-994 GLOSSARY CI 5 confidence interval; CUMC 5 Columbia University Medical Center; dIVH 5 delayed intraventricular hemorrhage; GCS 5 Glasgow Coma Scale; ICH 5 intracerebral hemorrhage; ICHOP 5 ICH Outcomes Project; iIVH 5 initial IVH; IQR 5 interquartile range; IVH 5 intraventricular hemorrhage; mRS 5 modified Rankin Scale; OR 5 odds ratio.Intracerebral hemorrhage (ICH) is associated with high mortality and unfavorable outcome.1 In order to improve clinical outcomes, research efforts have primarily been directed towards understanding modifiable factors that worsen outcome, e.g., hematoma expansion after hospital admission.2,3 One recent study showed that delayed intraventricular hemorrhage (dIVH; intraventricular hemorrhage [IVH] that is not present on the initial admission CT but happens during hospitalization) occurs in up to every fifth ICH patient without IVH on initial CT and is independently associated with in-hospital mortality. 4 These results from one single-center study suggest that this subgroup of ICH patients is both at increased risk of unfavorable outcome and a promising target group, in which unfavorable outcome might potentially be prevented by frequent follow-up CTs and aggressive intervention. Before embarking on costly clinical trials to test this hypothe...
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