Correlation between regional cerebral oxygen saturation at admission and outcomes in patients with hypertensive intracerebral hemorrhage

Abstract

Objective To investigate the effect of regional cerebral oxygen saturation (rSO2) at admission on the outcomes in patients with hypertensive intracerebral hemorrhage. Methods Patients with hypertensive intracerebral hemorrhage were enrolled prospectively. Near-infrared spectroscopy was used to detect rSO2 at admission, and various baseline data were collected. Six months after onset, the clinical outcomes were assessed by the modified Rankin Scale scores, and 0-2 was defined as good outcome and >2 was defined as poor outcome. Multivariate logistic regression analysis was used to determine the independent influencing factors for clinical outcomes. Results A total of 103 patients with hypertensive intracerebral hemorrhage were enrolled, including 36 females and 67 males (mean age 64.41±11.70 years). The mean baseline score of the National Institutes of Health Stroke Scale (NIHSS) was 17.12±8.58, the mean baseline Glasgow Coma Scale (GCS) score was 9.82±2.54; 66 patients had basal ganglion hematoma, 37 had thalamus hemorrhage; hematoma volumes were 2-80 ml, mean 26.53±18.94 ml; hematoma extended into the ventricles in54 patients, and 55 patients had midline shift; 70 (68.0%) had good outcomes, and 33 (32.0%) had poor outcomes, 12 (11.7%) of them died. There were significant differences in age, hematoma volume, baseline NIHSS score, baseline GCS score, rSO2 at admission, and the proportions of hematoma extended into the ventricles, midline shift, brain herniation, received hematoma evacuation between the good outcome group and the poor outcome group. Multivariate logistic regression analysis showed that older age (odds ratio [OR] 1.124, 95% confidence interval [CI] 1.035-1.221; P=0.005), larger hematoma volume (OR 1.158, 95% CI 1.053-1.274; P=0.002), higher baseline NIHSS score (OR 1.340, 95% CI 1.093-1.642; P=0.005), and lower rSO2 at admission (OR 2.212, 95% CI 1.033-4.737; P=0.041) were the independent risk factors for poor outcome at 6 months after onset. Conclusions rSO2 at admission was associated with the poor outcomes in patients with hypertensive intracerebral hemorrhage. Key words: Cerebral Hemorrhage; Hypertension; Oximetry; Spectroscopy, Near-Infrared; Treatment Outcome