{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:59:54Z","timestamp":1792166394580,"version":"4.4.0"},"reference-count":27,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,1,27]],"date-time":"2022-01-27T00:00:00Z","timestamp":1643241600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Intracranial hemorrhage (ICH) is a dreaded complication of both cancer and its treatment. To evaluate the characteristics and clinical outcomes of cancer patients with ICH, we identified all patients with ICH who visited The University of Texas MD Anderson Cancer Center emergency department between 1 September 2006 and 16 February 2016. Clinical and radiologic data were collected and compared. Logistic regression analyses were used to determine the association between clinical variables and various outcomes. During the period studied, 704 confirmed acute ICH cases were identified. In-hospital, 7-day, and 30-day mortality rates were 15.1, 11.4, and 25.6%, respectively. Hypertension was most predictive of intensive care unit admission (OR = 1.52, 95% CI = 1.09\u20132.12, p = 0.013). Low platelet count was associated with both in-hospital mortality (OR = 0.96, 95% CI = 0.94\u20130.99, p = 0.008) and 30-day mortality (OR = 0.98, 95% CI = 0.96\u20131.00, p = 0.016). Radiologic findings, especially herniation and hydrocephalus, were strong predictors of short-term mortality. Among known risk factors of ICH, those most helpful in predicting cancer patient outcomes were hypertension, low platelet count, and the presence of hydrocephalus or herniation. Understanding how the clinical presentation, risk factors, and imaging findings correlate with patient morbidity and mortality is helpful in guiding the diagnostic evaluation and aggressiveness of care for ICH in cancer patients.<\/jats:p>","DOI":"10.3390\/jcm11030643","type":"journal-article","created":{"date-parts":[[2022,1,27]],"date-time":"2022-01-27T22:00:56Z","timestamp":1643320856000},"page":"643","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Characteristics and Outcomes of Intracranial Hemorrhage in Cancer Patients Visiting the Emergency Department"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0063-8461","authenticated-orcid":false,"given":"Aiham","family":"Qdaisat","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5170-0822","authenticated-orcid":false,"given":"Sai-Ching J.","family":"Yeung","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristhiam H.","family":"Rojas Hernandez","sequence":"additional","affiliation":[{"name":"Section of Benign Hematology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pavani","family":"Samudrala","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1626-2657","authenticated-orcid":false,"given":"Mona","family":"Kamal","sequence":"additional","affiliation":[{"name":"Symptom Research Department, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8359-0533","authenticated-orcid":false,"given":"Ziyi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9659-6755","authenticated-orcid":false,"given":"Adriana H.","family":"Wechsler","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.gheart.2014.01.003","article-title":"The global burden of hemorrhagic stroke: A summary of findings from the gbd 2010 study","volume":"9","author":"Krishnamurthi","year":"2014","journal-title":"Glob. Heart"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.5853\/jos.2016.00864","article-title":"Epidemiology, risk factors, and clinical features of intracerebral hemorrhage: An update","volume":"19","author":"An","year":"2017","journal-title":"J. Stroke"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"302","DOI":"10.12688\/f1000research.16357.1","article-title":"Recent advances in spontaneous intracerebral hemorrhage","volume":"8","author":"Garg","year":"2019","journal-title":"F1000Research"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1111\/1742-6723.12936","article-title":"Incidence and outcome of subarachnoid haemorrhage in the general and emergency department populations in queensland from 2010 to 2014","volume":"30","author":"Chu","year":"2018","journal-title":"Emerg. Med. Australas. EMA"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1212\/WNL.0b013e31829e6eff","article-title":"Mortality after hemorrhagic stroke: Data from general practice (the health improvement network)","volume":"81","author":"Gaist","year":"2013","journal-title":"Neurology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/S1474-4422(09)70340-0","article-title":"Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: A systematic review and meta-analysis","volume":"9","author":"Luitse","year":"2010","journal-title":"Lancet Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2918","DOI":"10.1016\/j.jstrokecerebrovasdis.2016.08.006","article-title":"Intracerebral hemorrhage outcomes in patients with systemic cancer","volume":"25","author":"Murthy","year":"2016","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1002\/ajh.22031","article-title":"Prediction model for mortality after intracranial hemorrhage in patients with leukemia","volume":"86","author":"Dayyani","year":"2011","journal-title":"Am. J. Hematol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1111\/jth.14336","article-title":"Intracranial hemorrhage with direct oral anticoagulants in patients with brain tumors","volume":"17","author":"Carney","year":"2019","journal-title":"J. Thromb. Haemost. JTH"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1736","DOI":"10.1111\/jth.13387","article-title":"A meta-analysis of intracranial hemorrhage in patients with brain tumors receiving therapeutic anticoagulation","volume":"14","author":"Zwicker","year":"2016","journal-title":"J. Thromb. Haemost. JTH"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1182\/blood-2015-02-626788","article-title":"Intracranial hemorrhage in patients with brain metastases treated with therapeutic enoxaparin: A matched cohort study","volume":"126","author":"Donato","year":"2015","journal-title":"Blood"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1212\/WNL.0b013e3181cef837","article-title":"Intracerebral and subarachnoid hemorrhage in patients with cancer","volume":"74","author":"Navi","year":"2010","journal-title":"Neurology"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Muster, V., and Gary, T. (2021). Contrasts in glioblastoma-venous thromboembolism versus bleeding risk. Cells, 10.","DOI":"10.3390\/cells10061414"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1007\/s11060-021-03716-8","article-title":"Prophylactic anticoagulation in patients with glioblastoma or brain metastases and atrial fibrillation: An increased risk for intracranial hemorrhage?","volume":"152","author":"Burth","year":"2021","journal-title":"J. Neurooncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1016\/S0140-6736(00)04561-X","article-title":"The canadian ct head rule for patients with minor head injury","volume":"357","author":"Stiell","year":"2001","journal-title":"Lancet"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.ajem.2019.02.003","article-title":"The ottawa subarachnoid hemorrhage clinical decision rule for classifying emergency department headache patients","volume":"38","author":"Wu","year":"2020","journal-title":"Am. J. Emerg. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.1016\/S0140-6736(09)60371-8","article-title":"Intracerebral haemorrhage","volume":"373","author":"Qureshi","year":"2009","journal-title":"Lancet"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1016\/j.jemermed.2020.03.039","article-title":"Clinical and cancer-related predictors for venous thromboembolism in cancer patients presenting to the emergency department","volume":"58","author":"Qdaisat","year":"2020","journal-title":"J. Emerg. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1002\/cncr.27772","article-title":"Incidence and predictors of venous thromboembolism (vte) among ambulatory high-risk cancer patients undergoing chemotherapy in the united states","volume":"119","author":"Khorana","year":"2013","journal-title":"Cancer"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1007\/s12028-015-0222-x","article-title":"Guideline for reversal of antithrombotics in intracranial hemorrhage: A statement for healthcare professionals from the neurocritical care society and society of critical care medicine","volume":"24","author":"Frontera","year":"2016","journal-title":"Neurocrit. Care"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1212\/01.WNL.0000138428.40673.83","article-title":"Warfarin, hematoma expansion, and outcome of intracerebral hemorrhage","volume":"63","author":"Flibotte","year":"2004","journal-title":"Neurology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1159\/000462985","article-title":"Volume and characteristics of intracerebral hemorrhage with direct oral anticoagulants in comparison with warfarin","volume":"7","author":"Adachi","year":"2017","journal-title":"Cerebrovasc. Dis. Extra"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"268","DOI":"10.3171\/2011.4.JNS101784","article-title":"Clinical outcome of leukemia patients with intracranial hemorrhage. Clinical article","volume":"115","author":"Chern","year":"2011","journal-title":"J. Neurosurg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1056\/NEJM196205032661802","article-title":"The quantitative relation between platelet count and hemorrhage in patients with acute leukemia","volume":"266","author":"Gaydos","year":"1962","journal-title":"N. Engl. J. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.jstrokecerebrovasdis.2009.03.003","article-title":"Prognostic role of mean platelet volume and platelet count in ischemic and hemorrhagic stroke","volume":"19","author":"Misirli","year":"2010","journal-title":"J. Stroke Cerebrovasc. Dis. Off. J. Natl. Stroke Assoc."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1159\/000328219","article-title":"Lower hemoglobin correlates with larger stroke volumes in acute ischemic stroke","volume":"1","author":"Kimberly","year":"2011","journal-title":"Cerebrovasc. Dis. Extra"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Tanne, D., Molshatzki, N., Merzeliak, O., Tsabari, R., Toashi, M., and Schwammenthal, Y. (2010). Anemia status, hemoglobin concentration and outcome after acute stroke: A cohort study. BMC Neurol., 10.","DOI":"10.1186\/1471-2377-10-22"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/3\/643\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:08:46Z","timestamp":1760134126000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/3\/643"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,27]]},"references-count":27,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["jcm11030643"],"URL":"https:\/\/doi.org\/10.3390\/jcm11030643","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-776084\/v1","asserted-by":"object"}]},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,27]]}}}