Abstract
The authors investigate the effects of clinical covariates upon the outcome of Intra-cerebral Hemorrhage (ICH) patients by applying a discriminate model of logistic regression. About 985 patients’s data with ICH have been collected using the International classification of diseases; ninth revision codes are also included. Diagnostic codes (434 for stroke and 431 for ICH) were used to identify patients and confirmed by neuro-imaging of the patients using CT scan and MRI. A univariate analysis of 88 covariates was undertaken and 46 of them reached statistical significance at an acceptable level of p < 0.05. The multivariable analysis exhibited a significant negative relationship between ICH and hypertension. The improvement among ICH patients having hypertension was found to be 0.5 with the p=0.001, ARR=0.5, 95% C.I. 0.3 – 0.8. The development among ICH patients using antihypertensive medicine was 1.3 with p = 0.021, ARR=1.3, 95% C.I. 1.0 – 1.6. Thus present study manifested that ICH has strong relationship with use of antihypertensive medicine. The rate of perfection in the patients physiological conditions using antihypertensive medicine at the time of discharge was 2.9 times acquiring p < 0.001, ARR=2.9, 95% C.I. 2.7 – 3.2 as compared to those who could not use antihypertensive medicine. The change in ARR from 1.3 to 2.9 times depict that the exercise of antihypertensive medicine and ICH outcome are positively associated. The fluctuations in ARR of hypertensive range of systolic blood pressure (SBP) also indicate that the blood pressure range and ICH outcome are negatively correlated. The neurological symptomoatology, indistinct speech and double vision are important factors of proposed models. Moreover, a clear decrease was found in mental status from normal to coma in most suitable model. Surgery is an important part of recovery, and estimated that the improvement among the ICH patients, who were treated under surgical aspects, was 1.4 times with significant p-value in the best models. The complication of pneumonia during treatment of ICH subjects has highly significant showing negative correlation with the given outcome variable. The current model has 89.3% area under the curve with sensitivity (82.6%), specificity (81.3%) and p-value (0.308). This indicates that the constructed model bestows the well performance of the ICH outcome and the model is considered as excellent.
Highlights
Human since his arrival on the earth has continuously encountered different risk factors affecting almost every facet of his life
The actual improvement among Intracerebral Hemorrhage (ICH) patients belonging to hypertensive lowest systolic blood pressure group (141–160 mm Hg) was 1.0 times (p = 0.004, adjusted relative risk (ARR)=1.0, 95% C.I. 0.8 – 1.2), for the range of (161–200 mm Hg) was 0.7 times (p = 0.004, ARR=0.7, 95% C.I. 0.4 – 1.0) and for the range of (>200 mm Hg) was 0.6 times (p = 0.004, ARR=0.6, 95% C.I. 0.2 – 1.3) as compared to the normal range (90 – 140 mm Hg) of blood pressure as operated in other variables
The improvement among ICH patients with coagulopathy was 0.5 times (p = 0.02, ARR=0.5, 95% C.I. 0.2 – 0.9) as compared to without coagulopathy when adjusted for other variables in the model
Summary
Human since his arrival on the earth has continuously encountered different risk factors affecting almost every facet of his life. It is mandatory to rightly estimate these factors to secure the resources of life. There are many ways to estimate these risk factors; one most applicable way to handle these issues is to utilize the statistical tools. The one identified technique is the application of modeling on the given set of variables. Multiple clinical variables were collected from a group of patients suffering from ICH1. ICH is a clinical condition / disorder that have important association with many common health risk factors, such as hypertension, diabetes mellitus etc. A systematic statistical analysis is required to find out actual clinical variables that affect adversely on clinical outcome of ICH
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