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.
Lim
Jae Kwan
JK
Department of Neurosurgery, College of Medicine, Hallym University, Seoul 150-030, South Korea.
Hwang
Hyung Sik
HS
Cho
Byung Moon
BM
Lee
Ho Kook
HK
Ahn
Sung Ki
SK
Oh
Sae Moon
SM
Choi
Sun Kil
SK
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