Multivariate analysis of risk factors of hematoma expansion in spontaneous intracerebral hemorrhage.
BACKGROUND
We focused on the cause of hematoma expansion after admission because the volume of hematoma after S-ICH plays a crucial role in the cause of mortality and morbidity.


METHODS
In a retrospective review, 51 patients with hematoma expansion of S-ICH were identified among 880 cases of S-ICH treated between 2001 and May 2006. We divided cases into 2 groups according to the time of hematoma expansion. An enlargement of hematoma within 2 weeks after hospitalization was categorized as the acute stage group and after 2 weeks was categorized as the chronic stage group. Spontaneous intracerebral hemorrhage without hematoma expansion group (100 cases) had been consecutively selected as a control group. We analyzed the risk factors of hematoma expansion in patients with S-ICH especially in the acute stage group.


RESULTS
Fifty-one of 880 patients had the enlargement of hematoma (5.8%). Forty-three (84%) of 51 cases were acutely developed and 8 cases (16%) were developed chronically. On univariate analysis there were significant differences in BP within the initial 48 hours (P < .0001), GOS (P < .0001), and previously taking anticoagulant agents (P = .0053). Especially the difference in SBP and DBP within 48 hours between groups was 19 (11%) and 13 mm Hg (14%), respectively. The DBP within the initial 24 hours had a meaningful odds ratio (1.06) on logistic regression analysis.


CONCLUSIONS
A reduction of BP by 15% (SBP < or =140 mm Hg, DBP < or =80 mm Hg) is necessary at acute stage in S-ICH.
Department of Neurosurgery, College of Medicine, Hallym University, Seoul 150-030, South Korea.
Jae Kwan
JK
Lim
Hyung Sik
HS
Hwang
Byung Moon
BM
Cho
Ho Kook
HK
Lee
Sung Ki
SK
Ahn
Sae Moon
SM
Oh
Sun Kil
SK
Choi
D000925:Anticoagulants / Q000009:adverse effects; D001794:Blood Pressure / Q000502:physiology; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000473:pathology*; D005260:Female; D023261:Glasgow Outcome Scale; D006406:Hematoma / Q000209:etiology / Q000473:pathology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
D000925:Anticoagulants