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Clinical Profiles and Predictors of Mortality in Intracerebral Hemorrhage: A Prospective Cohort Study From Western

Nirali Dave1, Alpesh Vora2, Parth Jani3

  • 1General Medicine, Government Medical College, Bhavnagar, Bhavnagar, IND.

Cureus
|October 29, 2025
PubMed

Insights

Intracerebral hemorrhage (ICH) mortality is predicted by hyperglycemia, hypertension, and low Glasgow Coma Scale (GCS) scores. Targeting these modifiable factors, especially speech disorders, is crucial for improving outcomes in low-resource settings.

Area of Science:

  • Neurology
  • Stroke Medicine
  • Public Health

Background:

  • Intracerebral hemorrhage (ICH) is a severe stroke type with high early mortality.
  • Understanding risk factors and predictors of death is vital for effective treatment, particularly in diverse healthcare settings.

Purpose of the Study:

  • To assess the prevalence of modifiable and non-modifiable risk factors in ICH patients.
  • To identify clinical, biochemical, and radiological predictors of mortality using established severity scales.

Main Methods:

  • An observational study of 100 consecutive ICH patients with altered sensorium was conducted over 12 months.
  • Data collected included demographics, comorbidities, clinical features, blood pressure, biochemical markers, hematoma characteristics, and severity scores (GCS, ICH, NIHSS).
  • Regression analysis was used to identify predictors of survival and mortality.

Main Results:

  • High rates of modifiable risk factors were observed: smoking (56%), alcohol use (40%), hypertension (42%), and diabetes (44%).
  • Common clinical features included hemiplegia (82%), speech disorders (68%), and altered sensorium (56%).
  • Predictors of increased mortality included altered sensorium, speech disorders, hyperglycemia, elevated blood pressure, higher ICH score, and need for ventilator support. Overall mortality was 33%.

Conclusions:

  • Admission hyperglycemia, hypertension, and neurological impairment (GCS ≤8) are significant modifiable predictors of ICH mortality.
  • Speech disorders and hyperglycemia emerged as novel, underprioritized prognostic factors.
  • Urgent targeting of these factors is recommended in low- to middle-income countries (LMICs).
Abstract

Keywords:
hyperglycemiaintracerebral hemorrhagelow- to middle-income countriesmortality predictorsspeech disorders

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