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Updated: Oct 11, 2025
Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
Hospital Arrival and Functional Outcome after Intracerebral Hemorrhage
José L Ruiz-Sandoval1, Javier Aceves-Montoya2, Erwin Chiquete3
1Department of Neurology, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jal.; Department of Neurosciences, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jal.; Mexico.
Insights
Less than half of intracerebral hemorrhage patients arrive within 6 hours. Early hospital arrival for ICH does not appear to impact short-term outcomes, despite influencing factors like hypertension treatment and seizures.
Area of Science:
- Neurology
- Public Health
- Emergency Medicine
Background:
- Intracerebral hemorrhage (ICH) is a severe neurological condition with high mortality.
- Patient outcomes in ICH are significantly influenced by the time elapsed before hospital presentation.
Purpose of the Study:
- To identify factors associated with early hospital arrival in ICH patients.
- To investigate the relationship between early hospital arrival and patient outcomes.
Main Methods:
- A multicenter registry study analyzed patients with confirmed ICH.
- Multivariate logistic regression and Cox proportional-hazards models were used to identify predictors of early arrival and in-hospital death.
Main Results:
- The median delay to hospital admission was 6.25 hours; 45.3% of patients arrived within 6 hours.
- Predictors for arrival within 6 hours included hypertension treatment, higher education levels, and seizures at onset.
- High systolic blood pressure, ICH score, and low Glasgow Coma Scale score predicted mortality.
Conclusions:
- Less than half of ICH patients present within the critical 6-hour window.
- Early hospital arrival in ICH patients was not associated with improved short-term outcomes in this cohort.
Background:
Intracerebral hemorrhage (ICH) is associated with an ominous outcome influenced by the time to hospital presentation.
Objective:
This study aims to identify the factors that influence an early hospital arrival after ICH and the relationship with outcome.
Methods:
In this multicenter registry, patients with confirmed ICH on CT scan and well-known time of symptoms onset were studied. Clinical data, arrival conditions, and prognostic scores were analyzed. Multivariate models were built to find independent predictors of < 6 h arrival (logistic regression) and in-hospital death (Cox proportional-hazards model).
Results:
Among the 473 patients analyzed (51% women, median age 63 years), the median delay since onset to admission was 6.25 h (interquartile range: 2.5-24 h); 7.8% arrived in < 1 h, 26.3% in < 3 h, 45.3% in < 6 h, and 62.3% in < 12 h. The in-hospital, 30-day and 90-day case fatality rates were 28.8%, 30.0%, and 32.6%, respectively. Predictors of arrival in < 6 h were hypertension treatment (odds ratios [OR]: 1.675, 95% confidence intervals [CI]: 1.030-2.724), ≥ 3 years of schooling (OR: 1.804, 95% CI: 1.055-3.084), and seizures at ICH onset (OR: 2.416, 95% CI: 1.068-5.465). Predictors of death (56.9% neurological) were systolic blood pressure > 180 mmHg (hazards ratios [HR]: 1.839, 95% CI: 1.031-3.281), ICH score ≥ 3 (HR: 2.302, 95% CI: 1.300-4.074), and admission Glasgow Coma Scale < 8 (HR: 4.497, 95% CI: 2.466-8.199). Early arrival was not associated with outcome at discharge, 30 or 90 days.
Conclusions:
In this study, less than half of patients with ICH arrived to the hospital in < 6 h. However, early arrival was not associated with the short-term outcome in this data set.
