Related Experiment Video
Updated: Jun 19, 2026
Intrastriatal Injection of Autologous Blood or Clostridial Collagenase as Murine Models of Intracerebral Hemorrhage
Published on: July 3, 2014
Prognostic determinants in patients with non traumatic intracerebral hemorrhage: a real life report
Luca Masotti1, Elisa Grifoni1, Lavinia Migli1
1Internal Medicine II, San Giuseppe Hospital, Empoli, Italy.
Insights
Nontraumatic intracerebral hemorrhage (ICH) is deadly, with early neurological worsening, hematoma enlargement, high Hemphill ICH scores, and midline shift predicting short-term mortality. Advanced age independently predicts long-term disability after ICH.
Area of Science:
- Neurology
- Neurosurgery
- Critical Care Medicine
Background:
- Nontraumatic intracerebral hemorrhage (ICH) is a severe neurological condition with high mortality and significant disability.
- Effective prognostic factor identification is crucial for managing ICH in real-world clinical settings.
Purpose of the Study:
- To identify prognostic factors influencing outcomes in patients with intracerebral hemorrhage (ICH) managed in routine clinical practice.
- To compare outcomes and patient characteristics between Intensive Care Unit (ICU) and Stroke Unit (SU) admissions for ICH.
Main Methods:
- Retrospective analysis of clinical and neuro-radiological data from 98 consecutive ICH patients over one year.
- In-hospital mortality and 90-day modified Rankin Scale (mRS) score ≥4 were primary outcome measures.
- Comparison of patient demographics, clinical presentation, radiological findings, and treatment between ICU and SU cohorts.
Main Results:
- In-hospital and 90-day mortality rates were 36.7% and 41.8%, respectively.
- Factors associated with death included larger ICH volume, irregular shape, lobar location, intraventricular hemorrhage, midline shift, hydrocephalus, hematoma enlargement, low Glasgow Coma Scale (GCS) score, early neurological worsening (ENW), higher Hemphill ICH score, and intubation.
- Early neurological worsening (ENW), hematoma enlargement, Hemphill ICH score ≥3, and midline shift >10 mm were independent predictors of in-hospital mortality. Age was an independent predictor of 90-day mRS ≥4.
Conclusions:
- Prognosis in real-world ICH management is significantly influenced by clinical and radiological factors.
- Early neurological worsening, hematoma enlargement, high Hemphill ICH score, and significant midline shift are critical for predicting short-term mortality.
- Patient age is a key independent risk factor for long-term neurological disability (90-day mRS ≥4) after ICH.
Abstract:
Background and aim: Nontraumatic intracerebral hemorrhage (ICH) remains a devastating disease for high in-hospital and long-term mortality and residual neurological disability. The aim of our study was to analyze the prognostic factors in patients managed for ICH in the real-life clinical practice.Materials and Methods: We retrospectively analyzed clinical and neuro-radiological data of consecutive patients admitted to our Hospital for ICH along 1 year. In-hospital mortality and 90-day modified Rankin scale (mRS) ≥4 were the study outcomes. Moreover, we compared patients admitted in Intensive Care Unit (ICU) with patients admitted in Stroke Unit (SU).Results: Ninety-eight patients with mean age ± SD 78 ± 12 years were enrolled. In-hospital and 90-day mortality were 36.7% and 41.8%, respectively. Patients who died had a significantly higher percentage of ICH volume >30 mL, irregular shape, lobar location, intraventricular hemorrhage (IVH), midline shift, hydrocephalus, hematoma enlargement, Glasgow Coma Scale (GCS) ≤9 at hospital admission, early neurological worsening (ENW), higher Hemphill ICH score, and underwent oro-tracheal intubation more frequently compared with patients who survived. Patients admitted to ICU were younger and significantly more critical compared with those who were admitted to SU. In-hospital mortality in patients admitted to ICU was 52.6% compared with 25% in patients admitted to SU (p < 0.01). Median mRS score at hospital discharge was 4 (IQR 3-5) and at 90 days was 4 (IQR 3-4). ENW, hematoma enlargement, Hemphill ICH score ≥3 and midline shift >10 mm were found independent risk factors for in-hospital mortality, while age was found as independent risk factor for 90-day mRS ≥4).Conclusion: In real life, prognosis of ICH is associated with clinical and radiological determinants. In our study ENW, hematoma enlargement, Hemphill ICH score ≥3 and midline shift >10 mm were associated with short-term mortality risk, while age with 90-day mRS ≥4.
Related Concept Videos
01:17Hemorrhagic Stroke l: Introduction
01:29Hemorrhagic Stroke ll: Pathophysiology