ABSTRACT
BACKGROUND: Obstructive sleep apnea (OSA) is related to increased systemic inflammation and arterial hypertension. We hypothesize that OSA is frequent in patients with acute hypertensive intracerebral hemorrhage (ICH) and is related to the perihematoma edema. METHODS: Thirty-two non-comatose patients with a hypertensive ICH underwent polysomnography in the acute phase. Perihematoma edema volume was measured on CT scans at admission, after 24 h (early control) and after 4-5 days (late control). The Spearman coefficient (r(s)) was used for correlations. RESULTS: OSA occurred in 19 (59.4%) patients. The apnea-hypopnea index was correlated with relative edema at admission CT (r(s) = 0.40; p = 0.031), early CT (r(s) = 0.46; p = 0.011) and at late CT (r(s) = 0.59; p = 0.006). CONCLUSIONS: OSA is highly frequent during the acute phase of hypertensive ICH and is related to perihematoma edema.
Subject(s)
Brain Edema/etiology , Hematoma/etiology , Intracranial Hemorrhage, Hypertensive/complications , Sleep Apnea, Obstructive/etiology , Acute Disease , Aged , Brain Edema/diagnostic imaging , Female , Hematoma/diagnostic imaging , Humans , Intracranial Hemorrhage, Hypertensive/diagnostic imaging , Logistic Models , Male , Middle Aged , Odds Ratio , Polysomnography , Prospective Studies , Risk Assessment , Risk Factors , Severity of Illness Index , Sleep Apnea, Obstructive/diagnosis , Time Factors , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: We aimed to validate three widely used scales in stroke research in a multiethnic Brazilian population. METHODS: The National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS) and Barthel Index (BI) were translated, culturally adapted and applied by two independent investigators. The mRS was applied with or without a previously validated structured interview. Interobserver agreement (kappa statistics) and intraclass correlation coefficients were calculated. RESULTS: 84 patients underwent mRS (56 with and 28 without a structured interview), 57 BI and 62 NIHSS scoring. Intraclass correlation coefficient was 0.902 for NIHSS and 0.967 for BI. For BI, interobserver agreement was good (kappa = 0.70). For mRS, the structured interview improved interobserver agreement (kappa = 0.34 without a structured interview; 0.75 with a structured interview). CONCLUSION: The NIHSS, BI and mRS show good validity when translated and culturally adapted. Using a structured interview for the mRS improves interobserver concordance rates.
