Document Type : Special Articles

Authors

• Babak Bakhshayesh ¹
• Mozaffar Hosseininezhad ¹
• Seyed Mohammad Seyed Saadat ²
• Morvarid Hajmanuchehri ³
• Ehsan Kazemnezhad ⁴
• Amir-Reza Ghayeghran ¹

¹ Department of Neurology, School of Medicine, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.

² School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

³ Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran.

⁴ Department of Biostatistics, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

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.