Admission Dehydration Status Portends Adverse Short-Term Mortality in Patients with Spontaneous Intracerebral Hemorrhage.

Felix Lehmann,Anna-Laura Potthoff,Patrick Schuss,Julian Zimmermann,Alexis Hadjiathanasiou,Florian Gessler,Matthias Schneider,Erdem Güresir,Christian Bode,Hartmut Vatter,Christian Putensen,Joshua D Bernstock,Valeri Borger,Lorena M Schenk,Motaz Hamed

doi:10.3390/jcm10245939

Abstract

The impact of dehydration at admission of patients with spontaneous intracerebral hemorrhage (ICH) on short-term mortality remains ambiguous due to scarce data. All of the consecutive patients with spontaneous ICH, who were referred to our neurovascular center in 2018/19, were assessed for hydration status on admission. Dehydration was defined by a blood urea-to-creatinine ratio > 80. In a cohort of 249 patients, 76 patients (31%) were dehydrated at the time of admission. The following factors were significantly and independently associated with increased 30-day mortality in multivariate analysis: “signs of cerebral herniation” (p = 0.008), “initial midline shift > 5 mm” (p < 0.001), “ICH score > 3” (p = 0.007), and “admission dehydration status” (p = 0.007). The results of the present study suggest that an admission dehydration status might constitute a significant and independent predictor of short-term mortality in patients with spontaneous ICH.

Highlights

An intracerebral hemorrhage (ICH) is one of the most fatal forms of stroke
Regarding the localization of ICH, supratentorial ICH appeared in 212 patients (85%) while infratentorial ICH was present in 37 patients (15%)
The findings of the present study demonstrated that patients with admission dehydration status were of older age and presented with poorer neurological status

Summary

Introduction

An intracerebral hemorrhage (ICH) is one of the most fatal forms of stroke. Depending on the localization (deep-seated versus lobar), different causes (e.g., hypertension, arteriovenous malformations, aneurysms, tumors) may account for such hemorrhage [1,2]. In addition to the consequences of the hemorrhage on the outcome/mortality of patients with ICH, intensive care therapy addresses additional risk factors/comorbidities unrelated to the hemorrhage [8]. These may include prolonged mechanical ventilation and the need for renal replacement therapy, among other complications of intensive care [9,10,11]. There have been only sporadic reports on the influence of admission dehydration status on short-term mortality in patients with ICH [20]

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