title: Mortality and functional disability after spontaneous intracranial hemorrhage: the predictive impact of overall admission factors.
abstract: To determine the effects of different prognostic factors, including previous antiplatelet therapy, admission data, and radiographic findings on discharge and 3-month neurological condition using modified Rankin scale (mRS) and mortality at 30 days and 3-month follow-up in patients presenting to the emergency department with spontaneous intracranial hemorrhage (sICH). Between January and July 2012, 120 consecutive patients (males 62%, females 38%), who were admitted within 48 h of symptoms onset, were included. We recorded the following data on admission: demographics; functional scores of ICH, Glasgow Coma Scale, and National Institutes of Health Stroke Scale; vital signs; smoking status; use of illicit drug; preadmission antiplatelet treatment; results of laboratory tests (platelet count, serum glucose, sodium and creatinine levels, and prothrombin time); and primary neuroimaging findings [intraventricular hemorrhage (IVH), midline shift, and hydrocephalus]. In multivariate analysis using adjusted model for demographics and prior antiplatelet therapy; functional scores, laboratory results, and diabetes history correlated with mortality during 30 days after the event. Moreover, the parameters on the initial computed tomography scan significantly increased 30-day fatality rate and was correlated with increase in the discharge mRS score of survivors. The odds ratio (OR) and 95% confidence interval (CI) of early mortality associated with IVH presentation was 2.34 (CI 1.76-3.02, p = 0.003). The corresponding ORs in those with midline shift displacement and hydrocephalus were 2.18 (95% CI 2.08-3.80, p = 0.01) and 1.62 (95% CI 1.01-2.63, p = 0.02), respectively. In patients with ICH, prognostic factors, include various clinical parameters and paraclinical findings of admission time.
authors.affiliation: Department of Neurology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Behnam
authors.initials: B
authors.lastname: Mansouri
authors.forename: Kamran
authors.initials: K
authors.lastname: Heidari
authors.forename: Shadi
authors.initials: S
authors.lastname: Asadollahi
authors.forename: Maryam
authors.initials: M
authors.lastname: Nazari
authors.forename: Farhad
authors.initials: F
authors.lastname: Assarzadegan
authors.forename: Afshin
authors.initials: A
authors.lastname: Amini
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000175:diagnosis* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011379:Prognosis; D020127:Recovery of Function
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