Background and purpose Limited data exist on health-related quality of life (HRQoL) after intracerebral haemorrhage (ICH). We aimed to determine baseline factors associated with HRQoL among participants of the pilot and main phases of the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trials (INTERACT 1 and 2).
Methods The INTERACT studies were randomised controlled trials of early intensive blood pressure (BP) lowering in patients with ICH (<6 hours) and elevated systolic BP (150–220 mm Hg). HRQoL was determined using the European Quality of Life Scale (EQ-5D) at 90 days, completed by patients or proxy responders. Binary logistic regression analyses were performed to identify factors associated with poor overall HRQoL.
Results 2756 patients were included. Demographic, clinical and radiological factors associated with lower EQ-5D utility score were age, randomisation outside of China, antithrombotic use, high baseline National Institutes of Health Stroke Scale (NIHSS) score, larger ICH, presence of intraventricular extension and use of proxy responders. High (≥14) NIHSS score, larger ICH and proxy responders were associated with low scores in all five dimensions of the EQ-5D. The NIHSS score had a strong association with poor HRQoL (p<0.001). Female gender and antithrombotic use were associated with decreased scores in dimensions of pain/discomfort and usual activity, respectively.
Conclusions Poor HRQoL was associated with age, comorbidities, proxy source of assessment, clinical severity and ICH characteristics. The strongest association was with initial clinical severity defined by high NIHSS score.
Trial registration numbers NCT00226096 and NCT00716079; Post-results.
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Collaborators INTERACT Investigators (see online only reference ‘Supplemental data 2_INTERACT Investigators.pdf’).
Contributors CD, DZ, CSA and SS contributed to the concept and rationale for the study. DZ and SS contributed to statistical analyses. CD, DZ, and Sato were responsible for the first draft of the manuscript. CD, DZ, XC, CSA and SS contributed to the interpretation of the results. All authors participated in the drafting and took responsibility for the content and integrity of this article.
Funding The National Health and Medical Research Council of Australia provided funding for this research.
Competing interests CSA received speaker fees from Takeda China and Advisory Committee reimbursement from Medtronic and Astra Zeneca. The other authors report no conflicts of interest.
Ethics approval Relevant ethics committee in countries involved.
Provenance and peer review Not commissioned; externally peer reviewed.