The outcome difference in patients with spontaneous intracerebral
The outcome difference in patients with spontaneous intracerebral hematoma ID 23049 Author: Zanda Lāse 1, dr. med. Juris Dzenis 2, 3, dr. Ilga Ķikule 1, 4 1 Faculty of Continuing Education, Rīga Stradiņš University, Riga, Latvia 2 Faculty of Medicine, University of Latvia, Riga, Latvia 3 Clinic of Neurosurgery, Pauls Stradiņš Clinical University Hospital, Riga, Latvia 4 Clinic of Vascular Neurology, RAKUS “Gaiļezers” Clinical University Hospital, Riga, Latvia Introduction. Spontaneous intracerebral hemorrhage (SIH) is the most devastating form of stroke, with high mortality and severe disability among survivors. The overall incidence of spontaneous ICH worldwide is 24. 6 per 100, 000 personyears with 30 -day mortality rate ranges from 35% to 52% with only 20% of survivors expected to have full functional recovery at 6 months. Aim. Compare patient with different (SIH) outcomes. Figure 3. Comparison GKS between groups. • Glasgowa Coma Scale (GCS) were higher in live patients average 13± 3 (p<0, 00). • patients that were dead average GKS were 7 ± 4 Material and Methods. A retrospective medical record review was performed in the Pauls Stradins Clinical University Hospital and in Riga East Clinical University Hospital Gailezers. Together we collected 200 records. Results. Demographics: Total of 157 patients were reviewed, 64 men and 93 women. Of all patience 77 were in live case(1. ) group 80 in lethal case (2. ). 30 25. 5 Percentage, % 25 15 Figure 4. Comparison SIH volume between groups. • average hematoma volume were bigger in dead patients (79± 79 ml) than live patients (14± 24 ml) (p<0, 00)). 19. 7 20 17 14. 6 13 40 5 35 40 -65 65 -79 Age, years Live cases Percentage, % 10 0 42. 8 45 10. 2 80+ 27. 3 30 25 20. 8 20 15 Death cases 10 Figure 1. Comparison between different ages groups and SIH outcome. • bad outcomes most pronounced were in age group 80+ y. o. second were in 45 -65 y. o. and third 66 -79 y. o. , (p<0, 00) • more SIH were in second group (n=63) 6. 5 2. 6 5 0 1 2 3 4 m. Rs 5 Figure 5. Outcome modified Rankin score in patients. • modified Rankin scale (m. Rs) after 30 day hospitalization most points were 3 (27, 3%) and 4 (42, 8%). 120 97 Percentage, % 100 100 72 67. 5 80 60 40 20 0 26 28. 8 0 1. 3 0 13 8. 8 1 2 3 ICH score points ICH score data Figure 2. Comparison systolic blood pressure between groups. • live patience group average systolic blood pressure were higher 188 ± 3, 9 mm. Hg (p=0, 02) 91. 3 4 5 Our data Figure 6. ICH score comparison with our data • comparing groups with point 0 and 2 we had bigger mortality rate than predicted • in groups with points 1, 3 and 4 in our study, mortality was lower • with a score of 5 there was 100% mortality in both groups Conclusions. Patients are more likely to die in age group 80+, onset systolic blood pressure and (GCS) are higher and SIH volumes are smaller in live cases. MRs after 30 day hospitalization are more likely to be 3 and 4 point. Lobar hematomas, IVH and perifocal edema are more pronounced in dead cases. ICH score would be useful to predict outcome of our patients.
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