Functional outcome and survival following spontaneous intracerebral hemorrhage: A retrospective population‐based study

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.

Case fatality of hospital-treated intracerebral hemorrhage in Finland – A nationwide population-based registry study

“…Our data showed that comorbidities were associated with a higher risk of death and a higher number of comorbidities was associated with a higher risk of death. Increasing CCI score has also previously been reported to be a predictor of severe disability or death within 3 months [13]. The only exception in our data was hypertension, a recorded diagnosis of which was associated with a smaller risk of death.…”

“…Indeed, Finland has attained a high level of acute stroke care capability [12]. Previous data have shown that preceding functional disability predicts severe disability or death after ICH [13]. The improved physical and cognitive performance levels of the Finnish elderly and the generally improved life expectance therefore also contribute [14][15][16].…”

Spontaneous Intracerebral Hemorrhage: Epidemiology, Clinical Profile and Short-Term Outcome in a Tertiary Hospital in Sub-Saharan Africa

“…week was 22.1%, at 3 months 39.2%, and at 12 months 44.9% [27]. Safatli On multivariate analysis, GCS < 9 and NIHSS between 15 -24 were independent predictors of mortality while mass effect and temperature > 37˚C were independent predictors of poor functional recovery after stroke.…”

Melatonin attenuates microglial activation and improves neurological functions in rat model of collagenase-induced intracerebral hemorrhage

“…ICH accounts for 10-15% of all strokes and is characterized by bleeding inside the brain parenchyma (4,5). Not only does ICH cause death, it causes severe, permanent disability in surviving patients (6). Hematoma formation is the primary cause of adverse outcomes in ICH (7).…”