Abstract
BackgroundAccurate and reliable clinical and radiological predictors of intracerebral hemorrhage (ICH) outcomes are needed to optimize treatment of ICH. The aim of this study was to investigate functional outcome and identify predictors of severe disability or death following ICH.Materials and methodsRetrospective population‐based study of spontaneous ICH. Clinical and radiological data were obtained from electronic medical records, and functional outcome estimated using the modified Rankin Scale (mRS) before ICH and at 3 and 12 months after ICH.ResultsFour hundred and fifty‐two patients were included (mean age 74.8 years, 45.6% females). Proportion of fatal outcome at 1 week was 22.1%, at 3 months 39.2%, and at 12 months 44.9%. Median mRS score before the ICH was 1 (interquartile range [IQR] 2); for survivors at 3 months, it was 5 (IQR 3); and at 12 months, it was 3 (IQR 2). Independent predictors of severe disability (mRS of 5) or death (mRS of 6) were use of oral antithrombotic drugs (OR 2.2, 95% CI 1.3–3.8, p = 0.04), mRS score before the ICH (OR 1.8, 95% CI 1.4–2.2, p < 0.001), Glasgow Coma Scale (GCS) on admission (OR 8.3, 95% CI 3.5–19.7, p < 0.001), hematoma volume >60 ml (OR 4.5, 05% CI 2.0–10.2, p < 0.001), and intraventricular hematoma extension (OR 1.8, 95% CI 0.8–4.2, p < 0.001).ConclusionIntracerebral hemorrhage is associated with high mortality, and more than one third of survivors end up with severe disability or death 3 months later. Predictors of severe disability or death were use of oral antithrombotic drugs, functional disability prior to ICH, low GCS on admission, larger hematoma volume, and intraventricular hematoma extension.
Highlights
Spontaneous intracerebral hemorrhage (ICH) accounts for approxi‐ mately 10% to 15% of all cases of stroke, but is generally associated with higher risk of death and greater loss of health over a lifetime than ischemic stroke (Cadilhac, Dewey, Vos, Carter, & Thrift, 2010; Lee, Hwang, Jeng, & Wang, 2010; van Asch et al, 2010)
Use of oral antithrombotic medications (OAM), high modified Rankin Scale (mRS) before stroke, Glasgow Coma Scale (GCS)60 ml, and intraventricular hemorrhage remained independent predictors of severe disability or death 3 months after the intracere‐ bral hemorrhage (ICH)
This retrospective population‐based study in a high resource setting shows that ICH is associated with high mortality, and the majority of survivors become dependent of care
Summary
Spontaneous intracerebral hemorrhage (ICH) accounts for approxi‐ mately 10% to 15% of all cases of stroke, but is generally associated with higher risk of death and greater loss of health over a lifetime than ischemic stroke (Cadilhac, Dewey, Vos, Carter, & Thrift, 2010; Lee, Hwang, Jeng, & Wang, 2010; van Asch et al, 2010). Level of consciousness and baseline volume of parenchymal hemorrhage have been shown to be independent pre‐ dictors of poor outcome (Davis et al, 2006; Flemming et al, 2001; Nilsson, Lindgren, Brandt, & Saveland, 2002; Safatli et al, 2016), whereas the impact of intraventricular extension and hematoma lo‐ cation remains more uncertain (Bhatia et al, 2013; Flemming et al, 2001) The goal of this population‐based study was to investigate functional outcome in patients with ICH in a high resource setting. We sought to identify predictors of severe disability or death following ICH
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
