Predictors of 30-day mortality in patients with spontaneous primary intracerebral hemorrhage
- Department of Neurosurgery, Informatics and Documentation, Friedrich Schiller University, Jena, Germany
- Department of Neurology, Informatics and Documentation, Friedrich Schiller University, Jena, Germany
- Department of Medical Statistics, Informatics and Documentation, Friedrich Schiller University, Jena, Germany
DOI:10.4103/2152-7806.187493
How to cite this URL: Safatli DA, Albrecht Günther, Schlattmann P, Schwarz F, Kalff R, Ewald C. Predictors of 30-day mortality in patients with spontaneous primary intracerebral hemorrhage. Surg Neurol Int 01-Aug-2016;7:. Available from: http://surgicalneurologyint.com/surgicalint_articles/predictors-of-30-day-mortality-in-patients-with-spontaneous-primary-intracerebral-hemorrhage/
Background:Intracerebral hemorrhage (ICH) is a life threatening entity, and an early outcome assessment is mandatory for optimizing therapeutic efforts.
Methods:We retrospectively analyzed data from 342 patients with spontaneous primary ICH to evaluate possible predictors of 30-day mortality considering clinical, radiological, and therapeutical parameters. We also applied three widely accepted outcome grading scoring systems [(ICH score, FUNC score and intracerebral hemorrhage grading scale (ICH-GS)] on our population to evaluate the correlation of these scores with the 30-day mortality in our study. We also applied three widely accepted outcome grading scoring systems [(ICH score, FUNC score and intracerebral hemorrhage grading scale (ICH-GS)] on our population to evaluate the correlation of these scores with the 30-day mortality in our study.
Results:From 342 patients (mean age: 67 years, mean Glasgow Coma Scale [GCS] on admission: 9, mean ICH volume: 62.19 ml, most common hematoma location: basal ganglia [43.9%]), 102 received surgical and 240 conservative treatment. The 30-day mortality was 25.15%. In a multivariate analysis, GCS (Odds ratio [OR] =0.726, 95% confidence interval [CI] =0.661–0.796, P P P = 0.009) were significant predictors for the 30-day mortality. After receiver operating characteristics analysis, we defined a “high-risk group” for an unfavorable short-term outcome with GCS 32 ml supratentorially or 21 ml infratentorially. Using Pearson correlation, we found a correlation of 0.986 between ICH score and 30-day mortality (P P = 0.001), and 0.924 between ICH-GS and 30-day mortality (P = 0.001).
Conclusions:GCS score on admission together with the baseline volume and localization of the hemorrhage are strong predictors for 30-day mortality in patients with spontaneous primary intracerebral hemorrhage, and by relying on them it is possible to identify high-risk patients with poor short-term outcome. The ICH score and the ICH-GS accurately predict the 30-day mortality.
Keywords: Cerebral hemorrhage, multivariate analysis, prognosis, risk factors, treatment outcome
