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Published on: October 15, 2021
Predicting in-hospital mortality in Iranian patients with spontaneous intracerebral hemorrhage
Babak Bakhshayesh1, Mozaffar Hosseininezhad1, Seyed Mohammad Seyed Saadat2
1Department of Neurology, School of Medicine, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.
Insights
Predictors of in-hospital mortality in intracerebral hemorrhage (ICH) patients were identified. Older age, diabetes, higher NIHSS scores, larger hematoma volume, and smaller perihematoma edema predict mortality.
Area of Science:
- Neurology
- Stroke Medicine
- Epidemiology
Background:
- Intracerebral hemorrhage (ICH) is a severe stroke subtype with high mortality.
- Effective clinical grading scales for ICH mortality prediction are lacking, particularly in developing regions.
- This study aimed to identify predictors of in-hospital mortality in Iranian ICH patients.
Purpose of the Study:
- To assess key predictors of in-hospital mortality in spontaneous intracerebral hemorrhage (ICH) patients.
- To establish a basis for a clinical grading scale for ICH mortality prediction.
- To provide data relevant for resource-limited settings.
Main Methods:
- Prospective study conducted from January 2010 to January 2011.
- Collected demographic, clinical, and laboratory data from ICH patients.
- Measured hematoma volume and perihematoma edema (PHE) using CT scans and ABC/2 formula.
- Employed logistic regression to identify independent predictors of in-hospital mortality.
Main Results:
- Analysis included 98 consecutive ICH patients (mean age 70.16 ± 12.52).
- Independent predictors of in-hospital mortality identified: older age (OR=1.12), diabetes mellitus (OR=10.86), higher NIHSS score (OR=1.41).
- Hematoma volume (OR=1.1) and smaller PHE (OR=0.75) were also significant predictors.
Conclusions:
- Older age, diabetes, elevated NIHSS, larger hematoma volume, and smaller PHE are crucial predictors of in-hospital mortality in ICH.
- These findings can inform clinical assessment and risk stratification for ICH patients.
- The identified factors may contribute to developing a practical grading scale for ICH mortality.
Background:
Intracerebral hemorrhage (ICH) is the most fatal subtype of stroke. Despite limited effective therapy, there is no accepted clinical grading scale to predict in-hospital mortality, especially in developing nations. The purpose of this study was to assess the predictors of in-hospital mortality among a sample of Iranian patients with spontaneous ICH for use at the time of the first evaluation.
Methods:
This prospective study was carried from January 2010 to the end of January 2011. Demographic, clinical, and laboratory data of ICH patients were collected. Hematoma volume and perihematoma edema (PHE) were measured on brain computed tomography scan using ABC/2 formula. Logistic regression analysis was performed to determine independent variables contributing to in-hospital mortality.
Results:
Of a total 167 consecutive ICH patients, 98 patients met inclusion criteria. Mean ± standard deviation age of patients was 70.16 ± 12.52. After multivariate analysis, five variables remained as independent predictors of in-hospital mortality included: age [odds ratio (OR) = 1.12, 95% confidence interval (CI) = 1.03-1.23, P = 0.009], diabetes mellitus (OR = 10.86, 95% CI = 1.08-109.24, P = 0.009), National Institutes of Health Stroke Scale (NIHSS) score (OR = 1.41, 95% CI = 1.08-1.68, P ≤ 0.001), as well as volume of hematoma (OR = 1.1, 95% CI = 1.03-1.17, P = 0.003), and PHE (OR = 0.75, 95% CI = 0.60-0.93, P = 0.010).
Conclusion:
Our results indicate that older age, diabetes mellitus, higher NIHSS, as well as larger volume of hematoma, and smaller PHE on admission are important predictors of in-hospital mortality in our ICH patients.
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