Nontraumatic spontaneous intracerebral hemorrhage: Baseline characteristics and early outcomes

Abstract

Background and PurposeHemorrhagic stroke, particularly nontraumatic spontaneous intracerebral hemorrhage (SICH), is a cerebrovascular condition with unfavorable outcomes. The aims of the present study were to evaluate patients who suffered from SICH and investigate the early outcomes in a single‐center study.MethodsDuring a study ‐period of 6 years (2008–2014), 613 consecutive patients (mean age, 72 ± 12.7 years; 51.1% female), who suffered from nontraumatic SICH and were treated at the Department of Neurology at the University Hospital of Schleswig‐Holstein, Campus Lübeck, Germany, were included and prospectively analyzed.ResultsDuring a mean hospitalization time of 12 days, 148 patients (24.1%) died, 47% of those within the first 2 days and 79% within the first week. The patients who died stayed at the hospital for a shorter time (3) than those who survived (p < .001). In the multivariate logistic regression, following parameters were found to be associated with the in‐hospital mortality: female sex (OR, 2.0; 95%‐CI, 1.2–3.4; p = .009), a NIHSS score> 10 (OR, 10.5; 95%‐CI, 5.6–19.5; p < .001), history of hypertension (OR, 0.35; 95%‐CI, 0.19–0.64; p = .001), previous oral anticoagulation (OR, 2; 95%‐CI, 1.0–3.8; p = .032), and intraventricular extension of hemorrhage (OR, 2.8; 95%‐CI, 1.7–4.7; p = .001). At discharge, 192 patients (41.2%) showed favorable outcomes (mRS ≤ 2) whereas the median mRS of patients who survived was 3 (IQR 2–4). The good functional outcome at discharge from the acute hospital was decreased by an age> 70 years (OR, 0.56; 95%‐CI, 0.35–0.9; p = .017), NIHSS score> 10 at admission (OR, 0.07; 95%‐CI, 0.04–0.13; p < .001), and development of pneumonia during hospitalization (OR, 0.35; 95%‐CI, 0.2–0.6; p < .001).ConclusionThe present study showed that SICH is a serious disease causing high mortality and disability, particularly in the early period after event.

DNA Hypomethylation of DOCK1 Leading to High Expression Correlates with Neurologic Deterioration and Poor Function Outcomes after Spontaneous Intracerebral Hemorrhage

“…These outcomes were similar to another study, which indicated large hematoma volume, male gender, deep bleeding site, and age between 51 and 60 years were the related factors of poor short-term prognosis in ICH [ 38 ]. A recent study reported by Al-Khaled et al indicated that the elderly and the patients with severe neurological injury showed lower survival rate, and the gender, history of hypertension, and bleeding site were relevant to prognosis of ICH [ 39 ].…”

Association of Hypertensive Intracerebral Hemorrhage with Left Ventricular Hypertrophy on Transthoracic Echocardiography

“…Among etiologies, hemorrhagic stroke accounts for approximately 15% of patients [2,3]. Spontaneous intracerebral hemorrhage (sICH) is associated with a high risk of short-term mortality and long-term functional dependence [3,4]. The most frequent pathophysiological mechanism causing sICH is chronic arterial hypertension with development and eventual rupture of microscopic pseudoaneurysms of penetrating arteries typically localized in the basal ganglia, thalami, pons, midbrain and cerebellum [5][6][7].…”

Developing and validating a mortality prediction model for ICH in ITP: a nationwide representative multicenter study

“…50,51 Infection complications were reported to occur in 20-31% of patients with ICH as a risk factor for a poor prognosis. [52][53][54][55] In fact, acute brain injury could lead to immunosuppression due to the dysregulation of brain-immune interactions, which accounts for the high incidence and poor prognosis of coinfection in ICH. Meanwhile, it has been noted that the use of glucocorticoids and rituximab in ITP patients exposes them to a higher risk of infection.…”