Independent Factors Associated with 30-Day In-Hospital Mortality from Acute Spontaneous Intracerebral Hemorrhage

Abstract

ObjectiveThis study aims to investigate independent factors associated with 30-day mortality in patients with acute spontaneous intracerebral hemorrhage before treatment. MethodsA retrospective analysis was performed on medical records of patients hospitalized with acute spontaneous intracerebral hemorrhage between 2019 and 2021. Data included personal history, hospital stay duration, symptom onset, chief complaint, underlying diseases, medication, and alcohol/smoking habits. Physical examination records comprised baseline blood pressure, Glasgow Coma Scale assessment, and pupil reaction evaluation. Diagnostic imaging, specifically CT brain scans, was examined for hemorrhage details. Multivariable logistic analysis was utilized for data analysis. ResultsAmong 663 cases, 185 (27.9%) experienced mortality. Risk factors for mortality included chronic kidney disease, ischemic heart disease, loss of follow-up in hypertension clinic, and pontine hemorrhage. Conversely, motor response, reactive pupils, and basal cistern persistence significantly decreased the risk of mortality in multivariable analysis. ROC analysis identified a motor response score of 5 as the cutoff for predicting survival. ConclusionChronic kidney disease, ischemic heart disease, loss of hypertension follow-up, motor response, reactive pupils, pontine hemorrhage, and basal cistern persistence were independent variables associated with the 30-day mortality rate in spontaneous intracerebral hemorrhage patients before treatment initiation. A motor response, pupil reaction, and basal cistern persistence serve as predictive tools for assessing mortality in SICH before treatment.