title: Intracerebral hemorrhage at young age: long-term prognosis.
abstract: OBJECTIVE
  Intracerebral hemorrhage (ICH) is a devastating disorder associated with dismal outcomes. The long-term mortality and functional outcome of ICH in young patients was studied - areas so far poorly investigated.
  
  
  METHODS
  A follow-up study was performed on a cohort of patients. Clinical and imaging data on ICH patients aged 16-49 were retrospectively obtained and linked with a nationwide cause-of-death register. The modified Rankin Scale (mRS) was evaluated for 30-day survivors at a visit 9.7 (7.0-12.0) years after ICH onset. Independent factors associated with mortality and unfavorable functional outcome (mRS 2-5) were sought by multivariate analysis.
  
  
  RESULTS
  Amongst the 268 1-month survivors, 1-year survival was 98.1% [95% confidence interval (CI) 96.2%-100%], 5-year survival 93.2% (89.3%-97.1%) and 10-year survival 88.8% (84.9%-92.7%). After adjustment for age and intraventricular hematoma extension, male sex [odds ratio (OR) 3.36, 95% CI 1.28-8.80] and diabetes (OR 2.64, 1.01-6.89) were associated with increased mortality. Unfavorable functional outcome emerged in 49%. After adjustment for confounders, age (OR 1.09 per 1 year, 95% CI 1.03-1.15), initial stroke severity (1.17 per one National Institutes of Health Stroke Scale score point, 1.08-1.27) and intraventricular hemorrhage (3.26, 1.11-9.55) were associated with unfavorable functional outcome.
  
  
  CONCLUSIONS
  Of every 10 survivors of acute phase ICH at a young age, one died within 10 years after onset, male sex and diabetes being associated with increased mortality. Half the survivors did not achieve a favorable functional outcome, which was predicted by increasing age, initial stroke severity and intraventricular hemorrhage.
authors: Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland.
authors: R-J
authors: http://orcid.org/0000-0002-4257-9335
authors: RJ
authors: Koivunen
authors: Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland.
authors: T
authors: T
authors: Tatlisumak
authors: Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland.
authors: J
authors: J
authors: Satopää
authors: Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland.
authors: M
authors: M
authors: Niemelä
authors: Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland.
authors: J
authors: J
authors: Putaala
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011379:Prognosis; D012042:Registries / Q000706:statistics & numerical data*; D012737:Sex Factors; D055815:Young Adult
keywords: functional outcome; intracerebral hemorrhage; mortality; prognosis; stroke in young adults