Prognosis of intracerebral hemorrhage after conservative treatment.
BACKGROUND
The aim of this population-based study was to determine the short-term prognosis of patients treated conservatively for spontaneous intracerebral hemorrhage (ICH), a disease with a high rate of mortality.


METHODS
During a 39-month period beginning in October 2007, 594 patients (mean age 72 ± 12 years; 52% female; median National Institutes of Health Stroke Scale [NIHSS] score 9) with spontaneous ICH were enrolled in this prospective, population-based study.


RESULTS
Of 594 patients, 74 (12%) died during hospitalization (10.3 ± 7 days). Adjusted logistic regression analyses revealed that the in-hospital mortality rate was significantly associated with age >80 years (odds ratio [OR] 3.1; 95% confidence interval [CI] 1.3-7.5; P = .01), NIHSS score >15 (OR 3.3; 95% CI 1.4-9.7; P = .007), unconsciousness at admission (OR 5.3; 95% CI 2.0-13.6; P = .001), and cerebral edema detected by cranial computed tomography at admission (OR 14.7; 95% CI 6.2-34.6; P < .001). At hospital discharge, 329 patients (63%) agreed to participate in the inquiry. At 3 months of follow-up, 55 (18%) of 309 patients died. The 3-month mortality rate correlated significantly with age >80 years (OR 3.5; 95% CI 1.4-8.7; P = .008), previous stroke (OR 4.1; 95% CI 1.6-10.3; P = .002), unconsciousness at admission (OR 5.7; 95% CI 2.4-13.9; P = .001), pneumonia suffered during hospitalization (OR 3.3; 95% CI 1.2-9.6; P = .02), and cerebral edema (OR 5.7; 95% CI 2.3-13.8; P < .001).


CONCLUSIONS
Our study may help clinicians estimate the short-term prognosis of patients treated conservatively for ICH.
Department of Neurology, University of Lübeck, Lübeck, Germany. Electronic address: Mohamed.al-khaled@neuro.uni-luebeck.de.
Mohamed
M
Al-Khaled
Department of Neurology, University of Lübeck, Lübeck, Germany.
Jürgen
J
Eggers
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D016009:Chi-Square Distribution; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D005858:Germany / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010351:Patient Discharge; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
Conservative treatment; epidemiology; intracerebral hemorrhage; mortality; prognosis; stroke