title: Plasma osmolality in acute spontanious intra-cerebral hemorrhage: Does it influence hematoma volume and clinical outcome?
abstract: BACKGROUND
  Neurological deterioration in acute spontaneous intra cerebral hemorrhage (ICH) may depend on hematoma volume, electrolyte imbalances, hydration status and other physiological parameters. Plasma osmolality is a marker of hydration. This study has examined the relationship of plasma osmolality with hematoma volume and clinical outcome.
  
  
  METHODS
  This is a prospective observational study included 75 patients with non-traumatic acute spontaneous ICH. Plasma osmolality, hematoma volume and clinical outcome in National Institute Health stroke scale (NIHSS) were measured on admission and on day 7 after treatment. Mean plasma osmolality was compared between those who died before day 7 and those who died after day 7. Plasma osmolality was also compared between patients with NIHSS score >20 and patients with NIHSS score ≤20. Paired t test, Pearson correlation coefficient and independent sample t test were done using SPSS software (version 17 for Windows).
  
  
  RESULTS
  There is no significant correlation between hematoma volume and plasma osmolality. Higher admission plasma osmolality was associated with early death [312.0 (±16.0) mOsm/kg for those who died before day 7 versus 297.0 (±14.7) mOsm/kg for those who died after day 7, P value =0.031]. Higher admission plasma osmolality was associated with very severe stroke [311.5 (±14.1) mOsm/Kg for patients with NIHSS score >20 versus 293.6 (±11.3) mOsm/kg for patients with NIHSS score ≤20, P value =0.000).
  
  
  CONCLUSIONS
  High plasma osmolality is a predictor of early mortality. Hematoma volume is not influenced by plasma osmolality.
authors.affiliation: Department of General Medicine, Burdwan Medical College, Burdwan, West Bengal, India.
authors.forename: Chiranjib
authors.initials: C
authors.lastname: Nag
authors.forename: Kamalesh
authors.initials: K
authors.lastname: Das
authors.forename: Mrinalkanti
authors.initials: M
authors.lastname: Ghosh
authors.forename: M R
authors.initials: MR
authors.lastname: Khandakar
keywords: Clinical outcome; hematoma volume; intra cerebral hemorrhage; osmolality