BACKGROUND Intracranial hemorrhage (ICH) is the most common neurologic complication of reversible cerebral vasoconstriction syndrome (RCVS). In this study, we compared hemorrhagic and non-hemorrhagic RCVS with an aim to evaluate the risk factors and short-term clinical outcomes of hemorrhagic lesions. METHODS We used the Nationwide Readmissions Database 2016-2017 to identify all hospitalizations due to RCVS. Predictors and clinical outcomes of ICH were analyzed using logistic regression analysis. RESULTS Among the total 1834 hospitalizations for RCVS during the study period (mean ± SD age:48.4 ± 15.6 years, female:75.8%), 768 (41.9%) had occurrence of ICH. Patients with ICH were more likely to be female (OR:2.72, 95% CI:1.86-3.97), have a history of hypertension (OR:1.63, 95% CI:1.20-2.22) and cocaine use (OR:3.11, 95% CI:1.49-6.51), and were less likely to have a history of diabetes (OR:0.52, 95% CI:0.32-0.84) and heart failure (OR:0.34, 95% CI:0.14-0.84). Hemorrhagic RCVS was associated with higher odds of cerebral edema (OR:10.71, 95% CI:5.75-19.97), new onset seizure (OR:2.24, 95% CI:1.08-4.61), respiratory failure (OR:2.40, 95% CI:1.37-4.22) and gastrostomy tube placement (OR:3.20, 95% CI:1.07-9.58). Patients with hemorrhagic lesions also had longer length of hospital stay (mean difference 5.5 days), higher hospital charges (mean difference $105,547), and a lower likelihood of discharge to home (OR:0.61, 95% CI:0.43-0.86). There was, however, no significant difference in the in-hospital mortality. CONCLUSIONS ICH affects nearly 42% of patients with RCVS and is associated with increased rate of other neurologic complications and adverse discharge disposition, thus putting into question the prevailing conception that RCVS is generally a benign disorder with a self-limiting clinical course.

中文翻译：

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可逆性脑血管收缩综合征出血性卒中的预测因素和结局

背景颅内出血（ICH）是可逆性脑血管收缩综合征（RCVS）最常见的神经系统并发症。在这项研究中，我们比较了出血性和非出血性 RCVS，目的是评估出血性病变的危险因素和短期临床结果。方法 我们使用 2016-2017 年全国再入院数据库来确定所有因 RCVS 住院的患者。使用逻辑回归分析分析 ICH 的预测因素和临床结果。结果 研究期间共 1834 人因 RCVS 住院（平均±标准差年龄：48.4±15.6 岁，女性：75.8%），768 人（41.9%）发生 ICH。ICH 患者更可能是女性（OR：2.72，95% CI：1.86-3.97），有高血压病史（OR：1.63，95% CI：1.20-2.22）和可卡因使用（OR：3.11，95 % CI:1.49-6.51), 并且不太可能有糖尿病史 (OR:0.52, 95% CI:0.32-0.84) 和心力衰竭 (OR:0.34, 95% CI:0.14-0.84)。出血性 RCVS 与脑水肿（OR：10.71，95% CI：5.75-19.97）、新发癫痫发作（OR：2.24，95% CI：1.08-4.61）、呼吸衰竭（OR：2.40，95%）相关CI：1.37-4.22）和胃造瘘管放置（OR：3.20，95% CI：1.07-9.58）。出血性病变患者的住院时间也更长（平均差 5.5 天），住院费用更高（平均差 $105,547），出院回家的可能性更低（OR：0.61，95% CI：0.43-0.86）。然而，住院死亡率没有显着差异。结论 ICH 影响近 42% 的 RCVS 患者，并且与其他神经系统并发症和不良出院处置的发生率增加有关，