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Updated: Apr 12, 2026
Massive Pontine Hemorrhage by Dual Injection of Autologous Blood
Published on: May 29, 2021
Three-year prognosis of first-ever primary pontine hemorrhage in a hospital-based registry
Zusen Ye1, Xiaoya Huang2, Zhao Han3
1Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, 2 Fuxue Lane, Wenzhou, Zhejiang Province 325000, People's Republic of China.
Insights
Primary pontine hemorrhage (PPH) mortality in China shows similar prognosis factors to other populations. Coma on admission and large hematoma volume are key predictors of poor long-term survival in PPH patients.
Area of Science:
- Neurology
- Neurosurgery
- Public Health
Background:
- Primary pontine hemorrhage (PPH) is a critical neurological event with limited data on long-term prognosis in China.
- Understanding PPH mortality and prognostic factors is crucial for patient management and public health strategies.
Purpose of the Study:
- To evaluate the 30-day and 3-year mortality rates of primary pontine hemorrhage (PPH) in a Chinese population.
- To identify factors influencing short-term and long-term prognosis in patients with PPH.
Main Methods:
- A hospital-based stroke registry identified 76 patients with first-ever PPH.
- Kaplan-Meier method assessed event rates; logistic and Cox regression analyses identified mortality predictors.
- Data were collected from April 2007 to March 2011.
Main Results:
- Coma on admission, hematoma volume ≥ 4 mL, and massive hemorrhage were linked to 30-day mortality.
- Coma on admission (HR 2.18) and hematoma volume ≥ 4 mL (HR 2.23) independently predicted 3-year mortality.
- While male mortality was higher, the difference was not statistically significant.
Conclusions:
- Short-term mortality and prognostic factors for PPH in China align with international findings.
- A low Glasgow Coma Scale score and large hematoma volume are associated with poorer 3-year survival after PPH.
- These findings aid in predicting outcomes and guiding treatment for PPH patients.
Abstract:
Our aim was to evaluate the mortality rate of primary pontine hemorrhage (PPH) and to determine the factors related to the prognosis. Limited data exist on the long-term prognosis and determinants of death in patients with PPH in China. Our study analyzed consecutive cases of first-ever PPH from April 2007 to March 2011 in a hospital-based stroke registry. Mortality rates during 30 day and 3 year follow-ups were analyzed. We used the Kaplan-Meier method to estimate the event rates and binary logistic regression analysis, and Cox proportional hazard regression analysis to identify predictors of short-term and long-term prognosis, respectively. A total of 76 patients were identified, 44 (57.89%) were men. Both 30 day and 3 year overall mortalities in men were higher than women but this different was not statistically significant. Coma on admission, hematoma ⩾ 4 mL and a massive hemorrhage were significantly related to 30 day mortality of PPH. Multivariate Cox proportional hazard regression revealed that coma on admission (hazard ratio [HR] 2.18; 95% confidence interval [CI] 1.16-4.13; p = 0.02) and hematoma ⩾ 4 mL (HR 2.23; 95% CI 1.25-3.96; p = 0.01) were independent predictors of 3 year mortality. In conclusion, the short-term mortality rate and factors related to the prognosis of Chinese patients with PPH are similar to those reported for other populations. A low Glasgow coma scale score on admission and a large hematoma volume may be related to poor 3 year prognosis after PPH.
