Functional Outcome Survival and Independent Risk Factors in Patients with Spontaneous Intracerebral Hemorrhage from Chronic Arterial Hypertension

Abstract

Background: C(CAH) carries high morbidity and mortality rate. Objective: This study investigates the functional outcome, survival and predictors of severe disability or death following ICH from CAH. Methods: A prospective study of 75 patients with spICH from CAH. The functional outcome was estimated using the modified Rankin Scale (mRS) before ICH and at 3, 6 and 12 months after ICH. Results: 75 patients were included (mean age 52 years, 56% males). Percentage of mortality at 1 week was 20%, at 3 months 34%, at 6 months 38%, and at 12 months 42%. Median mRS score before ICH was 1; for survivors at 3, 6 and 12 months, it was 5, 4 and 3 respectively. Independent predictors of severe disability (mRS of 5) or death (mRS of 6) were mRS score before the ICH (RR 2.1, 95% CI 1.3-3.8, p=0.01), Glasgow Coma Scale (GCS) on admission (RR 4.3, CI 2.1-6.6, p 60ml (RR 3.2, CI 1.8-6.2, p=0.005), infra-tentorial location of ICH (RR 2.2, CI 1.3-5.5, p=0.03), intraventricular hematoma (RR 3.4, CI 2.4-6.8, p 180/110 mm Hg for >24 hours after ictus (RR 3.2, CI 1.3-4.5, p=0.002). Conclusion: SpICH from CAH is associated with high mortality, and about one third of survivors end up with severe disability or death 3 months later. Predictors of severe disability or death were functional disability prior to ICH, low GCS on admission, larger hematoma volume, infratentorial location of ICH, persistently elevated BP and intraventricular hematoma.