{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:12:25Z","timestamp":1792084345523,"version":"4.4.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Hematoma enlargement (HE) after intracerebral hemorrhage (ICH) is a therapeutic target for improving outcomes. Hemostatic therapies to prevent HE may be more effective the earlier they are attempted. An understanding of HE in first 1 to 2 hours specifically in the prehospital setting would help guide future treatment interventions in this time frame and setting.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>\n              Patients with spontaneous ICH within 4 hours of symptom onset were prospectively evaluated between May 2014 and April 2020 as a prespecified substudy within a multicenter trial of prehospital mobile stroke unit versus standard management. Baseline computed tomography scans obtained &lt;1, 1 to 2, and 2 to 4 hours postsymptom onset on the mobile stroke unit in the prehospital setting were compared with computed tomography scans repeated 1 hour later and at 24 hours in the hospital. HE was defined as &gt;6 mL if baseline ICH volume was\n              <jats:italic>&lt;<\/jats:italic>\n              20 mL and 33% increase if baseline volume &gt;20 mL. The association between time from symptom onset to baseline computed tomography (hours) and HE was investigated using Wilcoxon rank-sum test when time was treated as a continuous variable and using Fisher exact test when time was categorized. Kruskal-Wallis and Wilcoxon rank-sum tests evaluated differences in baseline volumes and HE. Univariable and multivariable logistic regression analyses were conducted to identify factors associated with HE and variable selection was performed using cross-validated L1-regularized (Lasso regression). This study adhered to STROBE guidelines (Strengthening the Reporting of Observational Studies in Epidemiology) for cohort studies.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              One hundred thirty-nine patients were included. There was no difference between baseline ICH volumes obtained &lt;1 hour (n=43) versus 1 to 2 hour (n=51) versus &gt;2 hours (n=45) from symptom onset (median [interquartile range], 13 mL [6\u201324] versus 14 mL [6\u201330] versus 12 mL [4\u201319];\n              <jats:italic>P<\/jats:italic>\n              =0.65). However, within the same 3 time epochs, initial hematoma growth (volume\/time from onset) was greater with earlier baseline scanning (median [interquartile range], 17 mL\/hour [9\u201335] versus 9 mL\/hour [5\u201323]) versus 4 mL\/hour [2\u20137];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Forty-nine patients had repeat scans 1 hour after baseline imaging (median, 2.3 hours [interquartile range. 1.9\u20133.1] after symptom onset). Eight patients (16%) had HE during that 1-hour interval; all of these occurred in patients with baseline imaging within 2 hours of onset (5\/18=28% with baseline imaging within 1 hour, 3\/18=17% within 1\u20132 hour, 0\/13=0% &gt;2 hours;\n              <jats:italic>P<\/jats:italic>\n              =0.02). HE did not occur between the scans repeated at 1 hour and 24 hours. No association between baseline variables and HE was detected in multivariable analyses.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>HE in the next hour occurs in 28% of ICH patients with baseline imaging within the first hour after symptom onset, and in 17% of those with baseline imaging between 1 and 2 hours. These patients would be a target for ultraearly hemostatic intervention.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.121.037591","type":"journal-article","created":{"date-parts":[[2022,4,4]],"date-time":"2022-04-04T09:01:23Z","timestamp":1649062883000},"page":"2352-2360","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":35,"title":["Hemorrhage Enlargement Is More Frequent in the First 2 Hours: A Prehospital Mobile Stroke Unit Study"],"prefix":"10.1161","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2262-0855","authenticated-orcid":true,"given":"Ritvij","family":"Bowry","sequence":"first","affiliation":[{"name":"Department of Neurology, McGovern Medical School, University of Texas Health Sciences Center, Houston (R.B., S.A.P., P.B., A.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8983-7792","authenticated-orcid":true,"given":"Stephanie A.","family":"Parker","sequence":"additional","affiliation":[{"name":"Department of Neurology, McGovern Medical School, University of Texas Health Sciences Center, Houston (R.B., S.A.P., P.B., A.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8712-6471","authenticated-orcid":true,"given":"Patti","family":"Bratina","sequence":"additional","affiliation":[{"name":"Department of Neurology, McGovern Medical School, University of Texas Health Sciences Center, Houston (R.B., S.A.P., P.B., A.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8091-6072","authenticated-orcid":true,"given":"Noopur","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Biostatics and Data Science (N.S., J.M.Y., A.P.J.), University of Texas School of Public Health, Houston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2505-0090","authenticated-orcid":true,"given":"Jose-Miguel","family":"Yamal","sequence":"additional","affiliation":[{"name":"Department of Biostatics and Data Science (N.S., J.M.Y., A.P.J.), University of Texas School of Public Health, Houston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suja S.","family":"Rajan","sequence":"additional","affiliation":[{"name":"Department of Management, Policy and Community Health (S.S.R.), University of Texas School of Public Health, Houston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1081-349X","authenticated-orcid":true,"given":"Asha P.","family":"Jacob","sequence":"additional","affiliation":[{"name":"Department of Biostatics and Data Science (N.S., J.M.Y., A.P.J.), University of Texas School of Public Health, Houston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4921-3608","authenticated-orcid":true,"given":"Kenny","family":"Phan","sequence":"additional","affiliation":[{"name":"Clinical Innovation and Research Institute, Memorial Hermann Hospital, Houston, TX (K.P., J.C.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9151-6015","authenticated-orcid":true,"given":"Alexandra","family":"Czap","sequence":"additional","affiliation":[{"name":"Department of Neurology, McGovern Medical School, University of Texas Health Sciences Center, Houston (R.B., S.A.P., P.B., A.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3667-4248","authenticated-orcid":true,"given":"James C.","family":"Grotta","sequence":"additional","affiliation":[{"name":"Clinical Innovation and Research Institute, Memorial Hermann Hospital, Houston, TX (K.P., 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