Predictive Evaluation of Mortality and Morbidity in Cases of Intracerebral Haemorrhage by Ct Scan

Abstract

BACKGROUNDStroke is the most common life-threatening neurological disease and is the third leading cause of death surpassed only by cancer and heart disease. Those who survive are usually left with permanent disability. Cerebral infarction is responsible for about 80% of all strokes, primary intracerebral haemorrhage for 10% and subarachnoid haemorrhage for 5%. These population are similar in all places where they have been reliably assessed by CT scan. Mortality statistics reveal that stroke type with high case fatality are intracerebral haemorrhage and total anterior circulation infarction.The aim of the current study was to determine the mortality rate and to evaluate the influence of various factors on the mortality of patients with intracerebral haemorrhage. MATERIALS AND METHODSThis is in-hospital based, cross-sectional descriptive study done on 62 patients in Department of Medicine and Radiology, Patna Medical College and Hospital, Patna. All patients above 14 years of age with features of primary intracerebral haemorrhage on CT scan were included. Patients with haemorrhages due to trauma, aneurysmal rupture, tumour, anticoagulant therapy and haemorrhagic transformation of cerebral infarct were excluded. RESULTSOut of 62 patients, 38 were males and 24 were females. The mean age for lobar and deep haemorrhages were 58.09 and 54.93 years, respectively. The mortality rate in acute stage was 43.54%. Remaining 65.4% survived till discharge at the end of acute hospitalisation. In present study, the location of intracerebral haemorrhage was lobar in 17.74%, deep ganglionic (ventricle) in 74.19%, cerebellar in 3.2% and pontine/midbrain in 4.8% of the patients. CONCLUSIONFactors independently associated with in-hospital mortality were Glasgow Coma Scale (GCS) score (≤8), hypertension, volume of haematoma, intraventricular haematoma and midline shift. Primary intracerebral haemorrhage is one of the common vascular insults with a relatively high rate of mortality and if survived results in multiple disabilities.