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The Predictor of Mortality within Six-Months in Patients with Spontaneous Cerebellar Hemorrhage: A Retrospective
Chih-Ya Chang1, Ching-Yueh Lin1, Liang-Cheng Chen1
1Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, No. 325, Sec. 2, Neihu District, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, School of Medicine, National Defense Medical Center, Taipei, Taiwan.
Insights
Radiological brainstem compression is a key predictor of early death in cerebellar hemorrhage (CH) patients. This finding helps in making critical treatment decisions for CH, improving patient outcomes.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Cerebellar hemorrhage (CH) has a high mortality rate compared to other intracranial hemorrhages.
- Improved imaging and early intervention have increased CH detection rates.
- Predictors for short-term mortality in CH are not well-established.
Purpose of the Study:
- To identify predictors of six-month mortality following acute spontaneous cerebellar hemorrhage.
- To provide clinically relevant data for educational and therapeutic decisions in CH management.
Main Methods:
- Retrospective analysis of 72 patients with acute spontaneous CH.
- Patients categorized into a six-month mortality group (n=21) and a survival group (n=51).
- Multivariate Cox proportional hazards regression used to determine independent predictors of mortality.
Main Results:
- Radiological brainstem compression was an independent predictor of six-month mortality (HR=23.5, p<0.001).
- Patients with brainstem compression had a median onset time to mortality of 5 days.
- Brainstem compression significantly increased mortality risk (HR=13.1, p<0.001).
Conclusions:
- This study identifies radiological brainstem compression as the first predictor of six-month mortality after CH.
- Patients exhibiting radiological brainstem compression are approximately 23 times more likely to die within six months of CH onset.
- Findings emphasize the critical role of brainstem compression in CH prognosis and management.
Background And Purpose:
The mortality rate of cerebellar hemorrhage (CH) is generally higher than other types of intracranial hemorrhage. Recently, the increased survey rate of CH has come from improved clinical imaging and earlier surgical intervention. Hence, the predictors of intermittent- (1 to 6 months) and long-term (> 6 months) mortality are clinically practical use for educational and therapeutic decisions. Unfortunately, the factors predictive mortality within six-month had not yet been systematically investigated.
Methods:
Seventy-two patients with acute spontaneous CH were retrospectively analyzed. The patients were divided into the six-month mortality group (n = 21, died within 6 months after CH onset) and survival group (n = 51, survived beyond 6 months). The independent predictors of six-month mortality were investigated by multivariate Cox proportional hazards regression.
Results:
The radiological brainstem compression (hazard ratios = 23.5; p < 0.001) was independent predictor of mortality within six-month after CH onset. The median onset time of six-month mortality was 5 days in patients with brainstem compression (p < 0.001) and the hazard ratios for the onset time was 13.1 compared with those without brainstem compression (95% CI, 4.7 to 36.3, p < 0.001).
Conclusions:
We report the first study that radiological brainstem compression predicted the mortality within six-month after onset of CH. Patients with radiological brainstem compression were about 23 times more likely to die within 6 months after CH than those without radiological brainstem compression.
