Using death and functional status as end points, we prospectively analyzed the outcome 6 months after spontaneous intracerebral hemorrhage in 166 patients admitted to an acute-care stroke unit on the first day of their stroke. Seventy-one patients (43%) died, 69 (42%) had a satisfactory outcome, and 26 (16%) had a poor functional outcome. Early (30-day) survival was correlated with morphologic parameters on the initial computed tomogram (hemorrhage size, midline shift, and intraventricular spread of the hemorrhage), while later (6-month) survival was correlated with age. Using logistic regression, we found five independent predictors of satisfactory outcome at 6 months: age, hemorrhage size, intraventricular spread of the hemorrhage, limb paresis, and communication disorders. Of these, age was the most important predictor by far.

SUMMARY A study is presented of a prospective analysis of survival rates in 157 patients with spinal cord injury consecutively admitted to the Pellegrin Hospital (University Hospital, Bordeaux, FrBnce). There was a 20% death rate, occurring in the first three months after injury. Three independent predictors ofsurvival in patients with spinal cord injuries (age, initial conscious level and respiratory assistance) were found by analysis of the course of the disorder. ResultsThe total sample consisted of 157 patients, 82% were males, with a male/female ratio of 4 to 1. During the first month of follow up, six subjects were lost while another five were lost in the following 6 months. The subjects ranged in ages from 5 to 86 years (mean age = 38 years), 42% of the subjects being over 40 years. A peak was found in the range of 20 to 40 years. Within this population 52% were tetraplegic patients, 40% were injured at the C4-C5-C6 level. Among the paraplegic patients (48% ofthe population) the lesions were mainly found at the T3-T4 (I1 %) and T1 1-T12 (13%) levels. 403

A longitudinal follow-up study of 149 spinal cord injured patients is presented. Ninety two patients have been visited and interviewed at home 7-10 years after injury (28% died during the follow-up). Disability was assessed using the Functional Independence Measure (FIM) , and was correlated with the neurological level, impairment and spasticity. The handicap was assessed using the Reintegration to Normal Living Index (RNLI). Multi variate analysis showed a correlation with age, neurological impairment, sexual impair ment, living conditions and social life. There was a high correlation with depression and the Functional Independence Measure. The early neurological examination correlated with their long term disability but not with their handicap.

SutntnaryThe authors present a prospective analysis with 1 year follow-up of about 157 consecutive spinal cord injured patients admitted to the Bordeaux CHU, over a 3 year period (1982)(1983)(1984)(1985). They present a method of analysing the walking status recovery in patients with spinal cord injuries from the early factors recorded on initial clinical examination. Twenty eight per cent of all patients are 'functional walkers', 1 year after injury. Three early factors were selected: age; the level of injury; and the initial Yale Scale Score. Only the age and the initial Yale Scale Score are independant predictive factors, according to the Cox model.The authors present a model of walking status recovery, 1 year after the injury, predicted from age and the initial Yale Scale Score.Key words: Spinal cord injury; Walking status; Prognosis.The prediction of the evolution of a spinal cord injury is necessary for the physician to develop a therapeutic strategy for the patient for functional activity and for any economic repercussions. When the initial emergency is resolved, the question is to know to what level a spinal injured patient will recover a functional autonomy in his daily life. We chose as functional criteria the walking status recovery, for this is the most commonly studied in the literature. We have to acknowledge that the physician does not give a prognosis of the possibilities of late recovery, according to the severity of the initial spinal shock. Our team operates very early in the evaluation of these injured patients and collaborates with the emergency team. As we are involved in the earliest care of the patients, we are confronted with the question of the prognosis from the very day of the injury.The purpose of this work is to establish a prediction for walking recovery in those with spinal cord injuries, from the early factors recorded on the initial clinical examination. Patients and tnethodsThe crucial point is to obtain a population as representative as possible of the 'theoretical' population of the spinal injured patients. If some selection bias exist, due to a defective protocol or simply to chance, the results may be totally wrong. To try to overcome the risk we consider the prognosis very early on on

SummaryThe authors present a prospective analysis of the functional outcome in 99 patients with traumatic tetraplegia consecutively admitted to the Pellegrin Hospital (University Hospital, Bordeaux, France). There was a 29% death rate. Eighteen months after injury, 33 % of the patients were dependent (not able to perform activities of daily living without the presence of a helping individual), 38% were independent. Two predictors of independence (age and initial Yale Scale Score) were found by a statistical analysis of the course of the disorder.