title: Factors influencing therapeutic strategy for patients with basal ganglia hemorrhage--could age play a potential role in final treatment decision?
abstract: BACKGROUND
  Hypertension-associated intracerebral hemorrhage, when compared with cerebral infarction and subarachnoid hemorrhage, is associated with worse clinical outcomes or major disability. Worse clinical outcomes have been observed in the elderly population though age as a factor influencing physicians' final treatment decision is not well determined.
  
  
  METHODS
  We studied 199 patients diagnosed with intracerebral hemorrhage (ICD code: ICD-9-CM-431) who visited a tertiary medical center from January 2003 to March 2006. Baseline characteristics, major medical histories (including co-morbidities), vital signs, neurological assessment (evaluated by the Glasgow Coma Scale), location of the hemorrhage, and the amount of hemorrhaging were all included as variables. A multivariate logistic regression model was chosen to evaluate the significant independent factors that could influence the physician's choice of treatment approach.
  
  
  RESULTS
  There were totally 110 patients meeting the inclusion criteria for enrollment. We observed that worse neurological function on-arrival (chi2 = 8.57, p = .01) and larger amount of bleeding (chi2 = 9.29, p = .01) were more likely to receive surgery. Multivariate logistic regression revealed that age, neurological function on-arrival, and the amount of hemorrhage were significant independent factors influencing the physicians' treatment decision (all p < .05).
  
  
  CONCLUSIONS
  Age, after adjustment for clinical variables representative of clinical severity, was an important factor in the final therapeutic decision. Our data suggest that a comprehensive evaluation of the patients' on-arrival status may be made and that advanced age should not be a determining factor in the choice of final treatment methods.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Jui-Peng
authors.initials: JP
authors.lastname: Tsai
authors.forename: Chung-Lieh
authors.initials: CL
authors.lastname: Hung
authors.forename: Shei-Ling
authors.initials: SL
authors.lastname: Ku
authors.forename: Charles Jia-Yin
authors.initials: CJ
authors.lastname: Hou
authors.forename: Hung-I
authors.initials: HI
authors.lastname: Yeh
authors.forename: Ray-E
authors.initials: RE
authors.lastname: Chang
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D020145:Basal Ganglia Hemorrhage / Q000175:diagnosis* / Q000628:therapy*; D016009:Chi-Square Distribution; D002755:Choice Behavior; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D038801:International Classification of Diseases; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D055815:Young Adult