Background Prestroke physical activity (PA) has been linked to improved outcomes after intracerebral haemorrhage (ICH), but its association with ICH volume is unknown. We aimed to investigate associations of prestroke PA with location-specific haematoma volume and the clinical outcome of ICH. Methods All patients with primary ICH, admitted to three hospitals between 2014 and 2019, were included. Patients performing light PA ≥4 hour/week the year before stroke were considered physically active. Haematoma volumes were assessed from admission brain imaging. Adjusted associations were estimated using multivariate linear and logistic regression models. Haematoma volume was explored as mediator to the relationship between prestroke PA and mild stroke severity (0–4 points on the National Institutes of Health Stroke Scale), a good 1-week functional status (0–3 points on the modified Rankin Scale) and 90-day survival. Average direct effects (ADE) and average causal mediation effects (ACME) were computed. Results Of 686 primary ICH cases, 349 were deep, 240 lobar and 97 infratentorial. Prestroke PA predicted smaller haematoma volumes in deep ICH (β=−0.36, SE=0.09, p<0.001) and lobar ICH (β=−0.23, SE=0.09, p=0.016). Prestroke PA was also associated with mild stroke severity (OR 2.53, 95% CI 1.59 to 4.01), a good 1-week functional status (OR 2.12, 95% CI 1.37 to 3.30) and 90-day survival (OR 3.48, 95% CI 2.06 to 5.91). Haematoma volume partly mediated the relationships between PA and stroke severity (ADE 0.08, p=0.004; ACME 0.10, p<0.001), 1-week functional status (ADE 0.07, p=0.03; ACME 0.10, p<0.001) and 90-day survival (ADE 0.14, p<0.001; ACME 0.05, p<0.001). Conclusions Light PA ≥4 hour/week prior to ICH was associated with smaller haematoma volumes in deep and lobar locations. Physically active patients with ICH had a higher likelihood of mild stroke, a good 1-week functional status and 90-day survival, in part mediated by smaller haematoma volumes on admission. Data are available upon reasonable request. Data cannot be made publicly available because of Swedish regulations. Researchers may apply to access anonymised data from Professor Katharina Stibrant Sunnerhagen after obtaining necessary approvals.

中文翻译：

---

卒中前体力活动与入院血肿量和脑出血的临床结果相关

背景 卒中前体力活动 (PA) 与脑出血 (ICH) 后预后的改善有关，但其与 ICH 体积的关系尚不清楚。我们的目的是研究卒中前 PA 与特定部位血肿量和 ICH 临床结果的关系。方法纳入2014年至2019年期间在3家医院收治的所有原发性脑出血患者。中风前一年每周进行轻度 PA ≥4 小时的患者被认为是体力活跃的。通过入院脑成像评估血肿量。使用多元线性和逻辑回归模型估计调整后的关联。血肿体积被探索为卒中前 PA 与轻度卒中严重程度（美国国立卫生研究院卒中量表 0-4 分）、良好的 1 周功能状态（改良 Rankin 量表 0-3 分）和90 天生存。计算平均直接效应（ADE）和平均因果中介效应（ACME）。结果 686例原发性脑出血中，深部349例，脑叶240例，幕下97例。卒中前 PA 预测深部 ICH (β=-0.36，SE=0.09，p<0.001) 和脑叶 ICH (β=-0.23，SE=0.09，p=0.016) 的血肿量较小。中风前 PA 还与轻度中风严重程度（OR 2.53，95% CI 1.59 至 4.01）、良好的 1 周功能状态（OR 2.12，95% CI 1.37 至 3.30）和 90 天生存率（OR 3.48，95% CI 2.06 至 5.91）。血肿体积部分调节 PA 与卒中严重程度（ADE 0.08，p=0.004；ACME 0.10，p<0.001）、1 周功能状态（ADE 0.07，p=0.03；ACME 0.10，p<0.001）和 90- 之间的关系。天生存率（ADE 0.14，p<0.001；ACME 0.05，p<0.001）。结论 ICH 前每周≥4 小时的轻度 PA 与深部和肺叶部位血肿体积较小相关。体力活跃的 ICH 患者发生轻度卒中的可能性较高，且 1 周功能状态良好，且 90 天生存率较高，部分原因是入院时血肿量较小。数据可根据合理要求提供。由于瑞典法规，数据无法公开。在获得必要的批准后，研究人员可以申请获取 Katharina Stibrant Sunnerhagen 教授的匿名数据。