Short-term mortality prognosis in spontaneous intracranial hemorrhage: A retrospective study at 115 People's Hospital, HCMC, Vietnam

Abstract

Background: Early prognosis of patients with spontaneous intracerebral hemorrhage (ICH) can help create individualized and optimized treatment plans for the patients.

Aims: This study evaluates short-term mortality and identifies risk factors in ICH patients at 115 People's Hospital within 30 days.

Design and methods: A retrospective cohort study was conducted involving 598 patients diagnosed with ICH by neurologists from December 2022 to June 2023. Diagnosis was confirmed by imaging, with symptoms appearing within 24 h of admission. Short-term mortality was defined as death within 30 days of onset.

Results: Among the 598 patients (mean age 58.4; 40% female), 110 (18.4%) died, while 488 (81.6%) survived. The ICH score (AUC = 95.75%; p < 0.001; optimal cutoff = 1.5) was more prognostic for mortality than the NIHSS score (AUC = 94.61%; optimal cutoff = 17.5; p < 0.001). Identified risk factors included age ≥ 80 (RR = 2.2, p = 0.002), ICH score ≥ 2 (RR = 38.4, p < 0.001), NIHSS score ≥ 16 (RR = 15.1, p < 0.001), hematoma volume ≥ 30 cm³ (RR = 15.1, p < 0.001), and the presence of intraventricular (RR = 7.2, p < 0.001) or subtentorial hemorrhage (RR = 2.8, p < 0.001).

Conclusions: The mortality rate for ICH was significant. The ICH score, NIHSS, and hematoma volume are effective in predicting mortality in spontaneous ICH patients.

Keywords: ICH score; NIHSS score; Vietnam; intracranial hemorrhage; short-term mortality prognosis.

Figure 1.

ROC curve analysis of ICH score, NIHSS score, and hematoma volume in predicting 30-day mortality in patients. ICH: intracerebral hemorrhage; NIHSS: National Institutes of Health Stroke Scale.