Functional trajectories between 90 days and 1 year after intracerebral haemorrhage: a Swedish Stroke Register (Riksstroke) study.

Authors

Marcus Johnsson, Björn M Hansen, Trine Apostolaki-Hansson, Mats Pihlsgård, Bo Norrving, Teresa Ullberg

Published in

European stroke journal. Volume 11. Issue 10. Oct 05, 2026.

Abstract

Functional outcome after ICH is commonly assessed at 90 days, although recovery and deterioration may continue beyond this conventional endpoint. Large-scale data describing within-patient functional trajectories beyond 90 days remain limited.
We conducted a register-based cohort study using the Swedish Stroke Register (Riksstroke), including adults with ICH between 2017 and 2021. Prestroke-independent 90-day survivors with available mRS data at both 90 days and 1 year were included. Functional trajectories were classified as improved, unchanged, worsened or died according to transitions across grouped mRS categories (0-2, 3, 4, 5 and 6 [death]). Multivariable logistic regression identified predictors of worsening or death and improvement.
Among 13,574 patients with ICH, 8583 prestroke-independent patients fulfilled eligibility criteria. Of these, 4797 were alive with available 90-day mRS data, and 3030 had complete mRS assessments at both 90 days and 1 year and were included in the primary analysis. Between 90 days and 1 year, 21.5% improved, 67.6% remained unchanged, 5.2% worsened and 5.8% died. Recovery at 1 year was most frequent among patients with mRS 3 at 90 days, of whom 62.4% achieved mRS 0-2, whereas 92.8% of patients with mRS 0-2 remained in the same category. Among patients with mRS 4-5 at 90 days, 20.4% improved to mRS 0-3 by 1 year. Increasing age and higher 90-day disability were associated with less favourable trajectories, whereas male sex was associated with greater likelihood of improvement.
Among prestroke-independent 90-day survivors with complete functional follow-up, functional outcomes after ICH remained dynamic beyond 90 days, particularly among patients with moderate disability. Nearly two-thirds of patients with moderate disability at 90 days achieved mRS 0-2 by 1 year, whereas more than 9 in 10 patients who were already classified as mRS 0-2 remained so. These findings suggest that longer-term outcome assessment may provide additional clinically relevant information in future ICH studies and clinical trials.

PMID:
42949837
Bibliographic data and abstract were imported from PubMed on 29 Oct 2026.

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