The impact of functional status at three months on long-term survival after spontaneous intracerebral hemorrhage.
OBJECTIVE
Few studies have assessed long-term prognosis and risk factors for death after spontaneous intracerebral hemorrhage (ICH). Patients who survive the acute phase may run different prognoses, depending on their disability, treatment, and lifestyle. The present study was performed to find out the predictors for long-term mortality after ICH.


METHODS
We assessed 7-year prognosis in a population-based cohort of patients who had survived the first 3 months after ICH (n=140). Controls (n=206) living in the same geographical area were randomly drawn from the population register and followed up for the same time.


RESULTS
Seven-year mortality was significantly higher in ICH patients than in controls (32.9 and 19.4%, respectively; P=0.0034). The annual risk for death in ICH patients was 5.6%, and the annual risk for fatal recurrent ICH was 1.3%. The ICH patients with good recovery at 3 months showed similar risk for death as controls. Recurrent ICH and pneumonia were the most common causes of death in ICH patients. Cigarette smoking, age, and diabetes seemed to increase the risk for death in patients and controls.


CONCLUSIONS
Survivors of ICH run a higher long-term risk for death than age- and sex-matched controls. However, those who show good recovery at 3 months run a similar outcome as controls.
Saloheimo
Pertti
P
Department of Neurology, Oulu University Hospital, Finland. pertti.saloheimo@fimnet.fi
Lapp
Tuuli-Maaria
TM
Juvela
Seppo
S
Hillbom
Matti
M
D000368:Aged; D001794:Blood Pressure; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D015331:Cohort Studies; D048909:Diabetes Complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000378:metabolism; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D012907:Smoking; D020521:Stroke / Q000473:pathology / Q000628:therapy; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome