title: Predictors of mortality and poor functional outcome in severe spontaneous intracerebral hemorrhage: a prospective observational study.
abstract: OBJECTIVE
  To analyze mortality and functional outcome in patients with severe spontaneous intracerebral hemorrhage (ICH), and identify the clinical characteristics, radiological findings and therapeutic procedures predictive of mortality in the Intensive Care Unit (ICU) and during hospitalization, as well as of poor functional results at 6 months.
  
  
  METHODS
  A prospective, observational study was carried out.
  
  
  METHODS
  Neurocritical Care Unit of a university hospital.
  
  
  METHODS
  Patients diagnosed with ICH were included over a period of 23 months.
  
  
  METHODS
  Demographic characteristics, cardiovascular risk factors, regular medication, laboratory test parameters, cranial CT findings, therapeutic procedures and outcome data.
  
  
  METHODS
  None.
  
  
  RESULTS
  A total of 186 patients with ICH met the inclusion criteria. Surgery to evacuate ICH was performed in 25.8% of the patients. The mortality rate was 46.7%. The modified Rankin score at 6 months was 5 (RI: 4.6). Multivariate Cox regression analysis showed the presence of diabetes, prior anticoagulation, as well as APACHE II severity and the type of bleeding on the cranial CT scan to be predictors of mortality and poor functional outcomes. On the other hand, neurosurgical procedures and intracranial pressure (ICP) monitoring were associated with better outcomes.
  
  
  CONCLUSIONS
  The presence of comorbidities such as diabetes, or previous anticoagulation, as well as the CT findings were associated to poorer outcomes. In contrast, ICP monitoring and early neurosurgery were predictive of longer survival and better functional outcomes.
authors.affiliation: Unidad de Neurocríticos, H.U. Virgen del Rocío, Sevilla, España.
authors.forename: A M
authors.initials: AM
authors.lastname: Ferrete-Araujo
authors.affiliation: Unidad de Neurocríticos, H.U. Virgen del Rocío, Sevilla, España; Instituto de Biomedicina, IBiS/CSIC, Universidad de Sevilla, Sevilla, España. Electronic address: juanj.egea.sspa@juntadeandalucia.es.
authors.forename: J J
authors.initials: JJ
authors.lastname: Egea-Guerrero
authors.affiliation: Instituto de Biomedicina, IBiS/CSIC, Universidad de Sevilla, Sevilla, España; Departamento de Medicina Preventiva y Salud Pública, Universidad de Sevilla, Sevilla, España.
authors.forename: Á
authors.initials: Á
authors.lastname: Vilches-Arenas
authors.affiliation: Unidad de Cuidados Neurointensivos, Sanatorio Pasteur. Unidad de Terapia Intensiva, Hospital Interzonal de Agudos «San Juan Bautista», Catamarca, Argentina.
authors.forename: D A
authors.initials: DA
authors.lastname: Godoy
authors.affiliation: Unidad de Neurocríticos, H.U. Virgen del Rocío, Sevilla, España; Instituto de Biomedicina, IBiS/CSIC, Universidad de Sevilla, Sevilla, España.
authors.forename: F
authors.initials: F
authors.lastname: Murillo-Cabezas
mesh_terms: D018806:APACHE; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001925:Brain Damage, Chronic / Q000453:epidemiology / Q000209:etiology; D002543:Cerebral Hemorrhage / Q000097:blood / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery; D005260:Female; D015600:Glasgow Coma Scale; D006454:Hemoglobins / Q000032:analysis; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000706:statistics & numerical data; D059906:Neuroimaging; D019635:Neurosurgical Procedures; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012422:Rupture, Spontaneous; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D006454:Hemoglobins
keywords: Hemorragia intraparenquimatosa; Intensive Care Unit; Intracerebral hemorrhage; Mortalidad; Mortality; Outcome; Pronóstico; Unidad de Cuidados Intensivos