Predicting the overall management outcome in patients with a subarachnoid hemorrhage accompanied by a massive intracerebral or full-packed intraventricular hemorrhage: a 15-year retrospective study.
BACKGROUND
Patients with a subarachnoid hemorrhage (SAH) accompanied by a massive intracerebral hemorrhage (ICH) or a full-packed intraventricular hemorrhage (IVH) have poor outcomes. We evaluated the clinical factors to predict the overall outcome in such patients.


METHODS
Data on nontraumatic SAH patients were collected and classified into 3 groups: the pure SAH group (SAH accompanied with neither ICH nor IVH), the ICH group (SAH accompanied with a massive ICH; hematoma 30 mL), and the IVH group (SAH and all ventricles were full-packed with hematoma). One hundred seventy-nine patients were in the ICH group and 109 in the IVH group. We evaluated clinical factors, such as the Hunt & Hess (H&H) score on admission, age, sex, history, rebleeding ratio, and the computerized tomography findings (SAH score).


RESULTS
The result of multivariate logistic regression analysis of clinical variables in the ICH group, good and intermediate H&H grades, younger age (<70), no rebleeding, and lower SAH score were associated with a favorable outcome. In the result of the multivariate logistic regression analysis of clinical variables in the IVH group, only a higher SAH score was associated with an unfavorable outcome.


CONCLUSIONS
In the ICH group, factors that could be used to predict a favorable outcome included good and intermediate H&H scores (1, 2, and 3) on admission, younger age (<70), and a lower SAH score. In the IVH group, the main factor that could be used to predict a favorable outcome was a lower SAH score.
Nakagawa
Toru
T
Department of Neurosurgery, Keio University School of Medicine, Tokyo, 326-0808, Japan. t-nakagawa@mvf.biglobe.ne.jp
Suga
Sadao
S
Mayanagi
Keita
K
Akaji
Kazunori
K
Inamasu
Joji
J
Kawase
Takeshi
T
D000328:Adult; D000367:Age Factors; D000368:Aged; D002552:Cerebral Ventricles / Q000098:blood supply* / Q000473:pathology*; D005260:Female; D006406:Hematoma; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000473:pathology / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome