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. 2023 Dec;27(12):895-901.
doi: 10.5005/jp-journals-10071-24578.

Unveiling the Crystal Ball: Predictors of Adverse Outcomes in Intracerebral Hemorrhage Patients

Awatif K Alsarrai Al-Alawi  1 , Darpanarayan Hazra  1 , Mohammed Jumaiel Khalfan Al-Hassani  2 , Amjad Said Abdullah Al-Jamoudi  2
Affiliations

Unveiling the Crystal Ball: Predictors of Adverse Outcomes in Intracerebral Hemorrhage Patients

Awatif K Alsarrai Al-Alawi et al. Indian J Crit Care Med. 2023 Dec.

Abstract

Introduction: Intracerebral hemorrhage (ICH) is a severe form of stroke with substantial morbidity and mortality worldwide. Despite its impact, research has often focused on ischemic strokes, making ICH an essential area to explore.

Methods: A retrospective cohort study spanning 5 years was conducted in an Oman-based tertiary care teaching hospital's emergency room. Data from patients diagnosed with spontaneous ICH, confirmed by cranial CT scans, were analyzed. Ethical approval was obtained.

Results: Among 163 emergency room (ER)-presented patients with ICH, 89 met the inclusion criteria. Most were male (69.66%), with hypertension (69/89) and diabetes mellitus (43/89) being common comorbidities. Hematoma size was a crucial predictor of poor outcomes, especially for larger hematomas (>60 cm³). Midline shift, intraventricular hemorrhages, elevated systolic and diastolic blood pressure, and low Glasgow Coma Scale (GCS) scores were significantly associated with unfavorable outcomes. However, variables such as age, gender, history of heart disease, hypertension, diabetes, and anticoagulant use did not show significant associations with disability outcomes. Favorable outcomes (mRS <3) were observed in 47.2% of patients, while 30.3% had a major disability (mRS 3-5), and 22.5% succumbed to their illness (mRS 6).

Conclusion: This study enhances our understanding of ICH outcomes, highlighting the importance of hematoma size, midline shift, intraventricular hemorrhage, blood pressure control, and GCS scores in predicting disability. Future research could explore additional prognostic factors and interventions for ICH patients.

How to cite this article: Al-Alawi AKA, Hazra D, Al-Hassani MJK, Al-Jamoudi ASA. Unveiling the Crystal Ball: Predictors of Adverse Outcomes in Intracerebral Hemorrhage Patients. Indian J Crit Care Med 2023;27(12):895-901.

Keywords: Cerebrovascular accident; Emergency room; Intracerebral hemorrhage; Poor outcome; Stroke.

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Conflict of interest statement

Source of support: Nil Conflict of interest: None

Figures

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Fig. 1
Strengthening the reporting of observational studies in epidemiology (STROBE) statement
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References

    1. Fernando SM, Qureshi D, Talarico R, Tanuseputro P, Dowlatshahi D, Sood MM, et al. Intracerebral hemorrhage incidence, mortality, and association with oral anticoagulation use. Stroke. 2021;52(5):1673–1681. doi: 10.1161/STROKEAHA.120.032550. - DOI - PubMed
    1. An SJ, Kim TJ, Yoon BW. Epidemiology, risk factors, and clinical features of intracerebral hemorrhage: An update. J Stroke. 2017;19(1):3–10. doi: 10.5853/jos.2016.00864. - DOI - PMC - PubMed
    1. Caceres JA, Goldstein JN. Intracranial hemorrhage. Emerg Med Clin North Am. 2012;30(3):771–794. doi: 10.1016/j.emc.2012.06.003. - DOI - PMC - PubMed
    1. Greenberg SM, Ziai WC, Cordonnier C, Dowlatshahi D, Francis B, Goldstein JN, et al. 2022 Guideline for the management of patients with spontaneous intracerebral hemorrhage: A guideline from the American Heart Association/American Stroke Association. Stroke. 2022;53(7):e282–e361. doi: 10.1161/STR.0000000000000407. - DOI - PubMed
    1. Montaño A, Hanley DF, Hemphill JC. Hemorrhagic stroke. Handb Clin Neurol. 2021;176:229–248. doi: 10.1016/B978-0-444-64034-5.00019-5. - DOI - PubMed

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