Predicting in-hospital mortality in Iranian patients with spontaneous intracerebral hemorrhage.

Babak Bakhshayesh; Mozaffar Hosseininezhad; Seyed Mohammad Seyed Saadat; Morvarid Hajmanuchehri; Ehsan Kazemnezhad; Amir-Reza Ghayeghran

Babak Bakhshayesh Department of Neurology, School of Medicine, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.
Mozaffar Hosseininezhad Department of Neurology, School of Medicine, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.
Seyed Mohammad Seyed Saadat School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Morvarid Hajmanuchehri Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran.
Ehsan Kazemnezhad Department of Biostatistics, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Amir-Reza Ghayeghran Department of Neurology, School of Medicine, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.

Keywords: Hematoma, Intracerebral Hemorrhage, Mortality, Outcome

Abstract

Background: Intracerebral hemorrhage (ICH) is the most fatal subtype of stroke. Despite limited effective therapy, there is no accepted clinical grading scale to predict in- hospital mortality, especially in developing nations. The purpose of this study was to assess the predictors of in- hospital mortality among a sample of Iranian patients with spontaneous ICH for use at the time of the first evaluation.
Methods: This prospective study was carried from January 2010 to the end of January 2011. Demographic, clinical, and   laboratory   data   of ICH   patients   were   collected. Hematoma volume and perihematoma edema (PHE) were measured   on brain computed tomography scan using ABC/2 formula. Logistic regression analysis was performed to determine independent variables contributing to in- hospital mortality.
Results: Of a total   167 consecutive   ICH   patients, 98 patients met inclusion criteria. Mean ± standard deviation age of patients   was 70.16 ± 12.52. Afte   multivariate analysis, five variables remained as independent predictors of   in-hospital    mortality    included:   age    [odds    ratio (OR) = 1.12, 95% confidence   interval (CI)   = 1.03-1.23, P = 0.009], diabetes mellitus (OR = 10.86, 95% CI = 1.08- 109.24, P = 0.009), National Institutes of Health Stroke Scale (NIHSS) score (OR = 1.41, 95% CI = 1.08-1.68, P ≤ 0.001), as well as volume of hematoma (OR = 1.1, 95% CI = 1.03-1.17, P = 0.003), and PHE (OR = 0.75, 95% CI = 0.60-0.93, P = 0.010).
Conclusion: Our results indicate that older age, diabetes mellitus, higher   NIHSS, as   well as larger   volume   of hematoma, and smaller PHE on admission are important predictors of in-hospital mortality in our ICH patients.

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