Predictors of 30-day mortality in patients with spontaneous primary intracerebral hemorrhage

Predictors of 30-day mortality in patients with spontaneous primary intracerebral hemorrhage

Diaa A. Safatli, Albrecht Günther, Peter Schlattmann, Falko Schwarz, Rolf Kalff, Christian Ewald

  1. Department of Neurosurgery, Informatics and Documentation, Friedrich Schiller University, Jena, Germany
  2. Department of Neurology, Informatics and Documentation, Friedrich Schiller University, Jena, Germany
  3. 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

Available from: http://surgicalneurologyint.com/surgicalint_articles/predictors-of-30-day-mortality-in-patients-with-spontaneous-primary-intracerebral-hemorrhage/

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