Prognosis of intracerebral hemorrhage after conservative treatment

Abstract

Background: The aim of this population-based study was to determine the short-term prognosis of patients treated conservatively for spontaneous intracerebral hemorrhage (ICH), a disease with a high rate of mortality.

Methods: During a 39-month period beginning in October 2007, 594 patients (mean age 72 ± 12 years; 52% female; median National Institutes of Health Stroke Scale [NIHSS] score 9) with spontaneous ICH were enrolled in this prospective, population-based study.

Results: Of 594 patients, 74 (12%) died during hospitalization (10.3 ± 7 days). Adjusted logistic regression analyses revealed that the in-hospital mortality rate was significantly associated with age >80 years (odds ratio [OR] 3.1; 95% confidence interval [CI] 1.3-7.5; P = .01), NIHSS score >15 (OR 3.3; 95% CI 1.4-9.7; P = .007), unconsciousness at admission (OR 5.3; 95% CI 2.0-13.6; P = .001), and cerebral edema detected by cranial computed tomography at admission (OR 14.7; 95% CI 6.2-34.6; P < .001). At hospital discharge, 329 patients (63%) agreed to participate in the inquiry. At 3 months of follow-up, 55 (18%) of 309 patients died. The 3-month mortality rate correlated significantly with age >80 years (OR 3.5; 95% CI 1.4-8.7; P = .008), previous stroke (OR 4.1; 95% CI 1.6-10.3; P = .002), unconsciousness at admission (OR 5.7; 95% CI 2.4-13.9; P = .001), pneumonia suffered during hospitalization (OR 3.3; 95% CI 1.2-9.6; P = .02), and cerebral edema (OR 5.7; 95% CI 2.3-13.8; P < .001).

Conclusions: Our study may help clinicians estimate the short-term prognosis of patients treated conservatively for ICH.

Keywords: Conservative treatment; epidemiology; intracerebral hemorrhage; mortality; prognosis; stroke.