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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
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Europa Medicophysica 1999 March;35(1):35-40

Copyright © 1999 EDIZIONI MINERVA MEDICA

language: English

Predictors of long-term case fatality (one-year) in primary intracerebral hemorrhage

Zorzon M., Masè G., Biasutti E., Vitrani B., Cazzato G.

Neurologic Clinic, University of Trieste, Italy


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BACKGROUND: To deter­mine, on clin­i­cal and radio­log­i­cal ­grounds, the prog­nos­tic fac­tors ­which may be asso­ciat­ed ­with the ­long-­term sur­vi­val ­after pri­mary intra­cer­e­bral hem­or­rhage.
METHODS: Design: prospective fol­low-up ­study. Setting: Hospitalized ­care. Patients: 126 con­sec­u­tive ­patients hos­pi­tal­ized with­in 24 ­hours of ­onset of supra­ten­to­ri­al pri­mary intra­cer­e­bral hem­or­rhage. The diag­no­sis was con­firmed by CT ­scan of the ­skull. No ­patient was ­lost to fol­low-up. Main out­come: potential ­risk fac­tors (clin­i­cal and radio­log­i­cal var­i­ables) for ­death ­were stud­ied pros­pec­tive­ly up to one ­year ­after hem­or­rhage.
RESULTS: In step­wise mul­ti­var­i­ate logis­tic regres­sion anal­y­sis, intra­ven­tric­u­lar spread­ing of the hem­or­rhage, ­large hem­or­rhage ­size, low Glasgow Coma Scale ­score and ­limb pare­sis (i.e. the ­patient can­not com­plete­ly over­come grav­ity in the ­range of ­motion) ­were sig­nif­i­cant inde­pen­dent pre­dic­tors of one-­year ­case fatal­ity.
CONCLUSIONS: The ­results sug­gest ­that ­long-­term ­case fatal­ity ­after an intra­cer­e­bral hem­or­rhage cor­re­lates ­with the sever­ity of ana­tom­i­cal ­lesions on CT and the lev­el of con­scious­ness on admis­sion, and ­also ­with the sever­ity of ­motor def­i­cits, imply­ing ­that the com­pli­ca­tions of rel­a­tive immo­bil­iza­tion can ­affect the ­long-­term prog­no­sis of pri­mary intra­cer­e­bral hem­or­rhage. Therefore eve­ry ­effort ­should be ­made to ­initiate reha­bil­i­ta­tion as ­soon as pos­sible to ­avoid the com­pli­ca­tions of immo­bil­ity.

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