Kidney dysfunction at the time of intracerebral hemorrhage is associated with increased in-hospital mortality: a retrospective observational cohort study.
OBJECTIVE
Renal dysfunction has been implicated as a risk factor for adverse outcomes after numerous cardiovascular events including stroke. However, most of the stroke studies have focused on long-term results and have primarily examined ischemic stroke. Therefore, we aimed to determine if renal dysfunction was associated with increased initial in-hospital mortality after intracerbral hemorrhage (ICH).


METHODS
Our retrospective, observational, cohort chart review evaluated the relationship between in-hospital mortality after ICH and renal function, assessed from admission estimated glomerular filtration rate (eGFR), calculated using the abbreviated modification of diet in renal disease equation, in 101 consecutive cases.


RESULTS
Survivors had higher admission eGFRs than those who died (88 ± 37 versus 59 ± 33 ml/minute/1.73 m(2); P<0.001). Similarly, mortality was higher in patients with eGFR <90 versus those >90 ml/minute/1.73 m(2) (40% versus 15%; P = 0.009). Univariate analysis indicated that in-hospital death was associated with intraventricular hemorrhage, ICH volume, age, eGFR <90 ml/minute/1.73 m(2), and admission values of serum creatinine, and blood urea nitrogen (P<0·05). Multivariable logistic regression (controlled for confounding variables) revealed that admission eGFR was an independent predictor of death; odds ratio 0.96; 95% confidence interval 0.92-0.99. We also found a negative correlation between eGFR and lesion size (P = 0.041); the lower the eGFR, the larger the lesion.


CONCLUSIONS
Renal dysfunction was an independent predictor of initial in-hospital mortality after stroke and hence may stratify risk in ICH patients.
Cardiovascular Research Institute, School of Medicine, Wayne State University, Detroit, MI 48201, USA. peter.whittaker@wayne.edu
Denise H
DH
Rhoney
Dennis
D
Parker
Scott R
SR
Millis
Peter
P
Whittaker
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000150:complications*; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate; D017052:Hospital Mortality; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology* / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019370:Observation; D012189:Retrospective Studies; D016019:Survival Analysis; D055815:Young Adult